Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Giannopoulos, S; Varcoe, RL; Lichtenberg, M; Rundback, J; Brodmann, M; Zeller, T; Schneider, PA; Armstrong, EJ.
Balloon Angioplasty of Infrapopliteal Arteries: A Systematic Review and Proposed Algorithm for Optimal Endovascular Therapy.
J Endovasc Ther. 2020; 27(4):547-564
Doi: 10.1177/1526602820931488
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PubMed
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- Co-authors Med Uni Graz
- Brodmann Marianne
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- Abstract:
- Endovascular revascularization has been increasingly utilized to treat patients with chronic limb-threatening ischemia (CLTI), particularly atherosclerotic disease in the infrapopliteal arteries. Lesions of the infrapopliteal arteries are the result of 2 different etiologies: medial calcification and intimal atheromatous plaque. Although several devices are available for endovascular treatment of infrapopliteal lesions, balloon angioplasty still comprises the mainstay of therapy due to a lack of purpose-built devices. The mechanism of balloon angioplasty consists of adventitial stretching, medial necrosis, and dissection or plaque fracture. In many cases, the diffuse nature of infrapopliteal disease and plaque complexity may lead to dissection, recoil, and early restenosis. Optimal balloon angioplasty requires careful attention to assessment of vessel calcification, appropriate vessel sizing, and the use of long balloons with prolonged inflation times, as outlined in a treatment algorithm based on this systematic review. Further development of specific devices for this arterial segment are warranted, including devices for preventing recoil (eg, dedicated atherectomy devices), treating dissections (eg, tacks, stents), and preventing neointimal hyperplasia (eg, novel drug delivery techniques and drug-eluting stents). Further understanding of infrapopliteal disease, along with the development of new technologies, will help optimize the durability of endovascular interventions and ultimately improve the limb-related outcomes of patients with CLTI.
- Find related publications in this database (using NLM MeSH Indexing)
- Algorithms -
- Amputation -
- Angioplasty, Balloon - adverse effects
- Angioplasty, Balloon - instrumentation
- Angioplasty, Balloon - mortality
- Chronic Disease -
- Clinical Decision-Making -
- Decision Support Techniques -
- Humans -
- Ischemia - diagnostic imaging
- Ischemia - mortality
- Ischemia - physiopathology
- Ischemia - therapy
- Limb Salvage -
- Patient Selection -
- Peripheral Arterial Disease - diagnostic imaging
- Peripheral Arterial Disease - mortality
- Peripheral Arterial Disease - physiopathology
- Peripheral Arterial Disease - therapy
- Popliteal Artery - diagnostic imaging
- Popliteal Artery - physiopathology
- Recurrence -
- Risk Factors -
- Treatment Outcome -
- Vascular Patency -
- Find related publications in this database (Keywords)
- atherectomy
- balloon angioplasty
- calcification
- chronic limb-threatening ischemia
- critical limb ischemia
- dissection
- drug-coated balloon
- drug-eluting stent
- endovascular revascularization
- infrapopliteal disease
- recoil
- residual stenosis
- restenosis
- stent