OBJECTIVE: To assess prospectively the feasibility and durability of subintimal angioplasty (SA) clinically and by duplex scans every 3 months. PATIENTS AND METHODS: Within a period of 54 months, we selected 96 patients with 100 occlusions (mean length: 11.5 cm) of femoro-popliteal or tibial arteries, for SA. RESULTS: The technical success rate was 88% and seven out of 12 failures were treated by conventional surgery. Five below-the-knee amputations were performed despite a patent recanalization. The following complications occurred: arterial perforation (6), arterial thrombosis (4), extensions beyond the planned re-entry site (5), and arterial dissection (2). Primary, assisted-primary and secondary patency rates were 61, 68 and 74%, respectively at 24 months. The 24 month-limb salvage and survival rates were 78 and 85%, respectively. Duplex imaging demonstrated 10 restenosis (five symptomatic >70%, five asymptomatic 30-70%), seven occlusions (five asymptomatic, two symptomatic treated by a bypass) and one asymptomatic dilatation. CONCLUSION: In a selected group of patients SA is feasible with a high initial technical success rate. SA is a good alternative in patients who are poor candidates for bypass surgery.
OBJECTIVE: To assess prospectively the feasibility and durability of subintimal angioplasty (SA) clinically and by duplex scans every 3 months. PATIENTS AND METHODS: Within a period of 54 months, we selected 96 patients with 100 occlusions (mean length: 11.5 cm) of femoro-popliteal or tibial arteries, for SA. RESULTS: The technical success rate was 88% and seven out of 12 failures were treated by conventional surgery. Five below-the-knee amputations were performed despite a patent recanalization. The following complications occurred: arterial perforation (6), arterial thrombosis (4), extensions beyond the planned re-entry site (5), and arterial dissection (2). Primary, assisted-primary and secondary patency rates were 61, 68 and 74%, respectively at 24 months. The 24 month-limb salvage and survival rates were 78 and 85%, respectively. Duplex imaging demonstrated 10 restenosis (five symptomatic >70%, five asymptomatic 30-70%), seven occlusions (five asymptomatic, two symptomatic treated by a bypass) and one asymptomatic dilatation. CONCLUSION: In a selected group of patientsSA is feasible with a high initial technical success rate. SA is a good alternative in patients who are poor candidates for bypass surgery.
Authors: Jeremy D Darling; Thomas C F Bodewes; Sarah E Deery; Raul J Guzman; Mark C Wyers; Allen D Hamdan; Hence J Verhagen; Marc L Schermerhorn Journal: J Vasc Surg Date: 2017-09-22 Impact factor: 4.268
Authors: Jeremy D Darling; John C McCallum; Peter A Soden; Lindsey Korepta; Raul J Guzman; Mark C Wyers; Allen D Hamdan; Marc L Schermerhorn Journal: J Vasc Surg Date: 2017-03-06 Impact factor: 4.268
Authors: Jeremy D Darling; Thomas F X O'Donnell; Sarah E Deery; Anthony V Norman; Giap H Vu; Raul J Guzman; Mark C Wyers; Allen D Hamdan; Marc L Schermerhorn Journal: J Vasc Surg Date: 2018-11 Impact factor: 4.268
Authors: Rosemarie Met; Krijn P Van Lienden; Mark J W Koelemay; Shandra Bipat; Dink A Legemate; Jim A Reekers Journal: Cardiovasc Intervent Radiol Date: 2008-04-15 Impact factor: 2.740