SUBINTIMAL RECANALIZATION AND STENTING FOR LONG SUPERFICIAL FEMORAL ARTERY OCCLUSIONS

Porcellini, M; Del Guercio, L; Carbone, F; Russo, A; Viola, D; Ficarelli, I

Risultato della ricerca: Paper

Abstract

Objective: To assess the feasibility and mid-term outcome of combined subintimal recanalization and stenting for the treatment of long superficialFebruary, and then Protégé® EverFlexTM) were placed in the whole subintimal space. The number and the length of stents was dictated from the length of the intentional subintimal dissection. The site of re-entry was chosen without compromise the feasibilty of a future bypass grafting. When completion arteriogram revealed residual stenosis, a post-dilatation was performed. Results: Twenty-eight patients (90.3%) underwent successful procedures, whereas two attempts failed because of inability to pass the guidewire through SFA occlusion and one because of arterial perforation. Two of the patients with unsuccessful SFA subintimal recanalization underwent successful leg bypass and one required an above-knee amputation. Arterial stenoses proximal or distal to the recanalized segment were treated with concomitant balloon angioplasties in five (16.2%) cases. The mean ABI increased to 0.87 (range 0.62-1.0) after the procedures. All the patients with successful SFA subintimal recanalization and stenting had resolution of symptoms and healing of ischemic lesions. Twenty-three of the 28 patients (82.1%) who had successful SFA procedures were patent at a mean follow-up of 21±6 months (range 2-57 months), and overall survival was 80.7%. Conclusions: Subintimal recanalization and routine stent placement allows high technical success rates and mid-term patency rates in the management of long SFA occlusions, with no significant procedure-related complications. femoral artery (SFA) occlusions. Methods: From 2002 to 2006, 31 consecutive patients (22 male, 9 female) with severe chronic ischemia were intended to be submitted to subintimal wire placement and routine stenting of SFA. The mean age of the patients was 67.3 years (range 61-79 years). Risk factors included diabetes mellitus (n=9, 29%) and end-stage renal failure (n=4, 12.9%). Thirteen patients (41.9%) were treated for disabling intermittent claudication, seven (22.6%) were treated for rest pain and 11 (35.5%) for ischemic ulcers or gangrene. The mean ankle-brachial index (ABI) was 0.51 (range 0.28-0.72). The procedures were performed under local anesthesia and using fluoroscopic guidance for entering subintimal space with an angled 0.035’ hydrophilic guidewire (Radifocus; Terumo, Japan); in 14 (45.1%) cases of flush occlusion of SFA, the procedures were made with associated duplex guidance to direct the devices into the SFA ostium. After advancement over the wire of a 5 Fr vertebral catheter (Terumo, Japan) and re-entry into the true lumen at the distal end of the lesion, self-expandable nitinol stents (Bard® LuminexxTM until 2006,
Lingua originaleEnglish
Stato di pubblicazionePublished - 2007

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Arteries
Stents
Ankle Brachial Index
Japan
Pathologic Constriction
Intermittent Claudication
Gangrene
Local Anesthesia
Femoral Artery
Amputation
Ulcer
Chronic Kidney Failure
Dissection
Dilatation
Leg
Knee
Diabetes Mellitus
Ischemia
Pain
Survival

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Porcellini, M; Del Guercio, L; Carbone, F; Russo, A; Viola, D; Ficarelli, I (2007). SUBINTIMAL RECANALIZATION AND STENTING FOR LONG SUPERFICIAL FEMORAL ARTERY OCCLUSIONS.

SUBINTIMAL RECANALIZATION AND STENTING FOR LONG SUPERFICIAL FEMORAL ARTERY OCCLUSIONS. / Porcellini, M; Del Guercio, L; Carbone, F; Russo, A; Viola, D; Ficarelli, I.

2007.

Risultato della ricerca: Paper

Porcellini, M; Del Guercio, L; Carbone, F; Russo, A; Viola, D; Ficarelli, I 2007, 'SUBINTIMAL RECANALIZATION AND STENTING FOR LONG SUPERFICIAL FEMORAL ARTERY OCCLUSIONS'.
Porcellini, M; Del Guercio, L; Carbone, F; Russo, A; Viola, D; Ficarelli, I. SUBINTIMAL RECANALIZATION AND STENTING FOR LONG SUPERFICIAL FEMORAL ARTERY OCCLUSIONS. 2007.
Porcellini, M; Del Guercio, L; Carbone, F; Russo, A; Viola, D; Ficarelli, I. / SUBINTIMAL RECANALIZATION AND STENTING FOR LONG SUPERFICIAL FEMORAL ARTERY OCCLUSIONS.
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title = "SUBINTIMAL RECANALIZATION AND STENTING FOR LONG SUPERFICIAL FEMORAL ARTERY OCCLUSIONS",
abstract = "Objective: To assess the feasibility and mid-term outcome of combined subintimal recanalization and stenting for the treatment of long superficialFebruary, and then Prot{\'e}g{\'e}{\circledR} EverFlexTM) were placed in the whole subintimal space. The number and the length of stents was dictated from the length of the intentional subintimal dissection. The site of re-entry was chosen without compromise the feasibilty of a future bypass grafting. When completion arteriogram revealed residual stenosis, a post-dilatation was performed. Results: Twenty-eight patients (90.3{\%}) underwent successful procedures, whereas two attempts failed because of inability to pass the guidewire through SFA occlusion and one because of arterial perforation. Two of the patients with unsuccessful SFA subintimal recanalization underwent successful leg bypass and one required an above-knee amputation. Arterial stenoses proximal or distal to the recanalized segment were treated with concomitant balloon angioplasties in five (16.2{\%}) cases. The mean ABI increased to 0.87 (range 0.62-1.0) after the procedures. All the patients with successful SFA subintimal recanalization and stenting had resolution of symptoms and healing of ischemic lesions. Twenty-three of the 28 patients (82.1{\%}) who had successful SFA procedures were patent at a mean follow-up of 21±6 months (range 2-57 months), and overall survival was 80.7{\%}. Conclusions: Subintimal recanalization and routine stent placement allows high technical success rates and mid-term patency rates in the management of long SFA occlusions, with no significant procedure-related complications. femoral artery (SFA) occlusions. Methods: From 2002 to 2006, 31 consecutive patients (22 male, 9 female) with severe chronic ischemia were intended to be submitted to subintimal wire placement and routine stenting of SFA. The mean age of the patients was 67.3 years (range 61-79 years). Risk factors included diabetes mellitus (n=9, 29{\%}) and end-stage renal failure (n=4, 12.9{\%}). Thirteen patients (41.9{\%}) were treated for disabling intermittent claudication, seven (22.6{\%}) were treated for rest pain and 11 (35.5{\%}) for ischemic ulcers or gangrene. The mean ankle-brachial index (ABI) was 0.51 (range 0.28-0.72). The procedures were performed under local anesthesia and using fluoroscopic guidance for entering subintimal space with an angled 0.035’ hydrophilic guidewire (Radifocus; Terumo, Japan); in 14 (45.1{\%}) cases of flush occlusion of SFA, the procedures were made with associated duplex guidance to direct the devices into the SFA ostium. After advancement over the wire of a 5 Fr vertebral catheter (Terumo, Japan) and re-entry into the true lumen at the distal end of the lesion, self-expandable nitinol stents (Bard{\circledR} LuminexxTM until 2006,",
keywords = "peripheral artery disease; subintimal angioplasty; stent;",
author = "{Porcellini, M; Del Guercio, L; Carbone, F; Russo, A; Viola, D; Ficarelli, I} and Bracale, {Umberto Marcello}",
year = "2007",
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T1 - SUBINTIMAL RECANALIZATION AND STENTING FOR LONG SUPERFICIAL FEMORAL ARTERY OCCLUSIONS

AU - Porcellini, M; Del Guercio, L; Carbone, F; Russo, A; Viola, D; Ficarelli, I

AU - Bracale, Umberto Marcello

PY - 2007

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N2 - Objective: To assess the feasibility and mid-term outcome of combined subintimal recanalization and stenting for the treatment of long superficialFebruary, and then Protégé® EverFlexTM) were placed in the whole subintimal space. The number and the length of stents was dictated from the length of the intentional subintimal dissection. The site of re-entry was chosen without compromise the feasibilty of a future bypass grafting. When completion arteriogram revealed residual stenosis, a post-dilatation was performed. Results: Twenty-eight patients (90.3%) underwent successful procedures, whereas two attempts failed because of inability to pass the guidewire through SFA occlusion and one because of arterial perforation. Two of the patients with unsuccessful SFA subintimal recanalization underwent successful leg bypass and one required an above-knee amputation. Arterial stenoses proximal or distal to the recanalized segment were treated with concomitant balloon angioplasties in five (16.2%) cases. The mean ABI increased to 0.87 (range 0.62-1.0) after the procedures. All the patients with successful SFA subintimal recanalization and stenting had resolution of symptoms and healing of ischemic lesions. Twenty-three of the 28 patients (82.1%) who had successful SFA procedures were patent at a mean follow-up of 21±6 months (range 2-57 months), and overall survival was 80.7%. Conclusions: Subintimal recanalization and routine stent placement allows high technical success rates and mid-term patency rates in the management of long SFA occlusions, with no significant procedure-related complications. femoral artery (SFA) occlusions. Methods: From 2002 to 2006, 31 consecutive patients (22 male, 9 female) with severe chronic ischemia were intended to be submitted to subintimal wire placement and routine stenting of SFA. The mean age of the patients was 67.3 years (range 61-79 years). Risk factors included diabetes mellitus (n=9, 29%) and end-stage renal failure (n=4, 12.9%). Thirteen patients (41.9%) were treated for disabling intermittent claudication, seven (22.6%) were treated for rest pain and 11 (35.5%) for ischemic ulcers or gangrene. The mean ankle-brachial index (ABI) was 0.51 (range 0.28-0.72). The procedures were performed under local anesthesia and using fluoroscopic guidance for entering subintimal space with an angled 0.035’ hydrophilic guidewire (Radifocus; Terumo, Japan); in 14 (45.1%) cases of flush occlusion of SFA, the procedures were made with associated duplex guidance to direct the devices into the SFA ostium. After advancement over the wire of a 5 Fr vertebral catheter (Terumo, Japan) and re-entry into the true lumen at the distal end of the lesion, self-expandable nitinol stents (Bard® LuminexxTM until 2006,

AB - Objective: To assess the feasibility and mid-term outcome of combined subintimal recanalization and stenting for the treatment of long superficialFebruary, and then Protégé® EverFlexTM) were placed in the whole subintimal space. The number and the length of stents was dictated from the length of the intentional subintimal dissection. The site of re-entry was chosen without compromise the feasibilty of a future bypass grafting. When completion arteriogram revealed residual stenosis, a post-dilatation was performed. Results: Twenty-eight patients (90.3%) underwent successful procedures, whereas two attempts failed because of inability to pass the guidewire through SFA occlusion and one because of arterial perforation. Two of the patients with unsuccessful SFA subintimal recanalization underwent successful leg bypass and one required an above-knee amputation. Arterial stenoses proximal or distal to the recanalized segment were treated with concomitant balloon angioplasties in five (16.2%) cases. The mean ABI increased to 0.87 (range 0.62-1.0) after the procedures. All the patients with successful SFA subintimal recanalization and stenting had resolution of symptoms and healing of ischemic lesions. Twenty-three of the 28 patients (82.1%) who had successful SFA procedures were patent at a mean follow-up of 21±6 months (range 2-57 months), and overall survival was 80.7%. Conclusions: Subintimal recanalization and routine stent placement allows high technical success rates and mid-term patency rates in the management of long SFA occlusions, with no significant procedure-related complications. femoral artery (SFA) occlusions. Methods: From 2002 to 2006, 31 consecutive patients (22 male, 9 female) with severe chronic ischemia were intended to be submitted to subintimal wire placement and routine stenting of SFA. The mean age of the patients was 67.3 years (range 61-79 years). Risk factors included diabetes mellitus (n=9, 29%) and end-stage renal failure (n=4, 12.9%). Thirteen patients (41.9%) were treated for disabling intermittent claudication, seven (22.6%) were treated for rest pain and 11 (35.5%) for ischemic ulcers or gangrene. The mean ankle-brachial index (ABI) was 0.51 (range 0.28-0.72). The procedures were performed under local anesthesia and using fluoroscopic guidance for entering subintimal space with an angled 0.035’ hydrophilic guidewire (Radifocus; Terumo, Japan); in 14 (45.1%) cases of flush occlusion of SFA, the procedures were made with associated duplex guidance to direct the devices into the SFA ostium. After advancement over the wire of a 5 Fr vertebral catheter (Terumo, Japan) and re-entry into the true lumen at the distal end of the lesion, self-expandable nitinol stents (Bard® LuminexxTM until 2006,

KW - peripheral artery disease; subintimal angioplasty; stent;

UR - http://hdl.handle.net/10447/43527

M3 - Paper

ER -