Ashkan Karimi1, Alexis L Lauria2, Behdad Aryavand3, Richard F Neville4. 1. Carient Heart and Vascular, Manassas, VA, 20109, USA. karimiasums@gmail.com. 2. Walter Reed National Military Medical Center, Bethesda, MD, 20889, USA. 3. Carient Heart and Vascular, Manassas, VA, 20109, USA. 4. Department of Surgery, INOVA Heart and Vascular Institute, Falls Church, VA, 22042, USA.
Abstract
PURPOSE OF REVIEW: This review intends to discuss the latest endovascular and surgical advancement in the treatment of critical limb-threatening ischemia (CLTI). RECENT FINDINGS: We discuss novel endovascular technological advancements such as intravascular lithotripsy, the Tack endovascular stent, the PQ Bypass DETOUR system, and the LimFlow System for deep venous arterialization (DVA) in the very high risk "no-option" CLTI population. We also discuss the increasing adoption of radial and pedal approaches for endovascular revascularization and the tibiopedal arterial minimally invasive (TAMI) technique. On the surgical front, we discuss the distal vein patch technique and surgical and hybrid DVA. Recent advancements in the treatment options of CLTI will likely lead to reducing the rate of major amputations if they are adopted in a collaborative environment in order to apply the most appropriate treatment option to each individual patient based on the anatomy, comorbidities, functional status, and local expertise.
PURPOSE OF REVIEW: This review intends to discuss the latest endovascular and surgical advancement in the treatment of critical limb-threatening ischemia (CLTI). RECENT FINDINGS: We discuss novel endovascular technological advancements such as intravascular lithotripsy, the Tack endovascular stent, the PQ Bypass DETOUR system, and the LimFlow System for deep venous arterialization (DVA) in the very high risk "no-option" CLTI population. We also discuss the increasing adoption of radial and pedal approaches for endovascular revascularization and the tibiopedal arterial minimally invasive (TAMI) technique. On the surgical front, we discuss the distal vein patch technique and surgical and hybrid DVA. Recent advancements in the treatment options of CLTI will likely lead to reducing the rate of major amputations if they are adopted in a collaborative environment in order to apply the most appropriate treatment option to each individual patient based on the anatomy, comorbidities, functional status, and local expertise.
Authors: Patrick J Geraghty; George L Adams; Andrej Schmidt; Michael Lichtenberg; Christian Wissgott; Ehrin J Armstrong; Klaus Hertting Journal: J Endovasc Ther Date: 2020-08 Impact factor: 3.487