Bosiers M, Deloose K, Verbist J, Peeters P
Department of Vascular Surgery, AZ St-Blasius, Dendermonde, Belgium.
Minerva Cardioangiol. 2009 Feb;57(1):117-29.
The application of percutaneous techniques for the treatment of peripheral arterial occlusive disease (PAOD) has gained widespread interest over the last decade. Together with the development of new endovascular tools and with an increasing operator experience, the minimal invasive percutaneous therapy became first line therapy at many institutions. Patients with critical limb ischemia (CLI) due to infrapopliteal lesions are often no good candidates infra-geniculate bypass surgery (IBS), as they often present with prohibitive comorbidities, inadequate conduit, and lack of suitable distal targets for revascularization. Therefore, CLI patients due to blockage of below-the-knee (BTK) arteries are in benefit of the endovascular approach: it offers the advantages of local anesthesia, potentially reduced costs (even anticipating the need for reintervention in many patients), shorter hospital stays The current article provides an overview of the diagnosis and endovascular treatment strategies for infrapopliteal lesions in patients with CLI and gives recommendations for future infrapopliteal device technology advancements.
在过去十年中，经皮技术在治疗外周动脉闭塞性疾病（PAOD）中的应用引起了广泛关注。随着新型血管内治疗工具的发展以及术者经验的增加，微创经皮治疗在许多机构已成为一线治疗方法。因腘下病变导致严重肢体缺血（CLI）的患者通常不是膝下旁路手术（IBS）的理想候选人，因为他们常伴有严重的合并症、血管移植材料不足以及缺乏合适的远端血管重建靶点。因此，因膝下（BTK）动脉阻塞导致CLI的患者受益于血管内治疗方法：它具有局部麻醉的优点，可能降低成本（甚至考虑到许多患者需要再次干预的情况），住院时间更短。本文概述了CLI患者腘下病变的诊断和血管内治疗策略，并对未来腘下装置技术的进步提出了建议。
