Objective To evaluate the rates of wound healing and limb preservation following angiosome-targeted infrapopliteal endovascular revascularization in the treatment of diabetic limb ischemia. Methods We performed a retr...Objective To evaluate the rates of wound healing and limb preservation following angiosome-targeted infrapopliteal endovascular revascularization in the treatment of diabetic limb ischemia. Methods We performed a retrospective analysis of data gathered from 102 infrapopliteal angioplasty cases(60 males and 42 females; mean age, 72 ± 11 years) with Fontaine IV ischemia(ankle-brachial index, ABI: 0.16 ± 0.06). Forty-seven angioplasties were performed based on the angiosome concept(direct revascularization, DR), while 55 did not incorporate the angiosome concept(indirect revascularization, IR). The curative effects of angioplasty were assessed by postoperative determinations of ABI performed every 3 months during clinical follow-up visits conducted to assess healing of the ischemic wound. Amputation and death events were recorded throughout the study. Results All 102 patients were successfully revascularized without complications, and during a mean follow-up period of 18 ± 11 months, the mean postoperative ABI improved to 0.84 ± 0.10. The postoperative 6 and 12 month healing rates in the DR group were 85.1% and 93.5%, respectively, while the limb-salvage rates were 100% and 93.5%, respectively. The postoperative 6 and 12 month healing rates in the IR group were 60% and 76.4%, respectively, while the limb-salvage rates were 90.1%, and 85.5%, respectively. Conclusion Angiosome-based Infrapopliteal angioplasty was associated with better wound healing and higher rates of limb salvage in cases of critical diabetic foot ischemia. Revascularization should be provided to patients who have undergone indirect perfusion of the ischemic angiosome, as acceptable rates of limb salvage are obtained.展开更多
Objective:To evaluate the efficacy of paclitaxel-coated balloon(PCB)in the treatment of extra-long femoropopliteal artery atherosclerotic disease(>30 cm).Materials and methods:Forty-nine patients with extra-long fe...Objective:To evaluate the efficacy of paclitaxel-coated balloon(PCB)in the treatment of extra-long femoropopliteal artery atherosclerotic disease(>30 cm).Materials and methods:Forty-nine patients with extra-long femoropopliteal artery atherosclerotic disease were treated with PCB alone in a single center from July 2016 to May 2018.Primary patency and freedom from clinically driven target lesion revascularization(FF-CDTLR)rates during 12 months were analyzed retrospectively.Results:All patients were followed up for 18.2±7.5 months,and the mean treated lesion length was 34.9±3.7 cm.The primary patency rates were 87.8%(43/49)and 71.4%(35/49)at 6 and 12 months,respectively.FFCDTLR was 91.8%(45/49)and 77.6%(38/49)at 6 and 12 months,respectively.No mortality or amputation occurred in these patients during the follow-up period.Conclusions:PCB has favorable clinical efficacy in patients with extra-long femoropopliteal artery atherosclerotic lesions.展开更多
基金supported by Liaoning Provincial Hospital Reform Key Clinical Diagnosis and Treatment Capacity Building Project(Youth Project):Diabetic Foot Multidisciplinary Cooperative Comprehensive Treatment Model Construction Project.(201507-201707)
文摘Objective To evaluate the rates of wound healing and limb preservation following angiosome-targeted infrapopliteal endovascular revascularization in the treatment of diabetic limb ischemia. Methods We performed a retrospective analysis of data gathered from 102 infrapopliteal angioplasty cases(60 males and 42 females; mean age, 72 ± 11 years) with Fontaine IV ischemia(ankle-brachial index, ABI: 0.16 ± 0.06). Forty-seven angioplasties were performed based on the angiosome concept(direct revascularization, DR), while 55 did not incorporate the angiosome concept(indirect revascularization, IR). The curative effects of angioplasty were assessed by postoperative determinations of ABI performed every 3 months during clinical follow-up visits conducted to assess healing of the ischemic wound. Amputation and death events were recorded throughout the study. Results All 102 patients were successfully revascularized without complications, and during a mean follow-up period of 18 ± 11 months, the mean postoperative ABI improved to 0.84 ± 0.10. The postoperative 6 and 12 month healing rates in the DR group were 85.1% and 93.5%, respectively, while the limb-salvage rates were 100% and 93.5%, respectively. The postoperative 6 and 12 month healing rates in the IR group were 60% and 76.4%, respectively, while the limb-salvage rates were 90.1%, and 85.5%, respectively. Conclusion Angiosome-based Infrapopliteal angioplasty was associated with better wound healing and higher rates of limb salvage in cases of critical diabetic foot ischemia. Revascularization should be provided to patients who have undergone indirect perfusion of the ischemic angiosome, as acceptable rates of limb salvage are obtained.
文摘Objective:To evaluate the efficacy of paclitaxel-coated balloon(PCB)in the treatment of extra-long femoropopliteal artery atherosclerotic disease(>30 cm).Materials and methods:Forty-nine patients with extra-long femoropopliteal artery atherosclerotic disease were treated with PCB alone in a single center from July 2016 to May 2018.Primary patency and freedom from clinically driven target lesion revascularization(FF-CDTLR)rates during 12 months were analyzed retrospectively.Results:All patients were followed up for 18.2±7.5 months,and the mean treated lesion length was 34.9±3.7 cm.The primary patency rates were 87.8%(43/49)and 71.4%(35/49)at 6 and 12 months,respectively.FFCDTLR was 91.8%(45/49)and 77.6%(38/49)at 6 and 12 months,respectively.No mortality or amputation occurred in these patients during the follow-up period.Conclusions:PCB has favorable clinical efficacy in patients with extra-long femoropopliteal artery atherosclerotic lesions.
