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Does patency matter in patients with critical limb ischemia undergoing endovascular revascularization?

作者信息

Baumann Frederic, Groechenig Ernst, Diehm Nicolas

机构信息

Clinical and Interventional Angiology, Inselspital, University Hospital Bern, Switzerland.

Clinical and Interventional Angiology, Kantonsspital Aarau, Switzerland.

出版信息

Ann Vasc Dis. 2014;7(1):11-6. doi: 10.3400/avd.ra.14-00019. Epub 2014 Mar 15.

DOI:10.3400/avd.ra.14-00019
PMID:24719656
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3968409/
Abstract

Restenosis is the major drawback in patients undergoing tibial angioplasty. In contrast to earlier observations, tibial patency was shown to impact on clinical outcomes in current randomized trials and is thus attributed more importance. Accordingly, intentions to reduce tibial restenosis have been intensified. Both drug-eluting balloons (DEB) and drug-eluting stents (DES) were shown to reduce tibial restenosis when compared with its plain counterparts. However, both endovascular technologies have its limitations for tibial arterial application. While DEB technology may not address elastic recoil, a pathophysiological mechanism frequently observed in tibial arteries and a significant contributor to restenosis, currently available DES do not fully address tibial arterial lesion morphology. Purpose of the present manuscript is to outline the problem and the incidence of tibial arterial restenosis, its importance on clinical outcomes and to provide an overview on technical developments aimed at its prevention.

摘要

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本文引用的文献

1
Early recoil after balloon angioplasty of tibial artery obstructions in patients with critical limb ischemia.严重肢体缺血患者胫动脉阻塞球囊血管成形术后的早期回缩
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Clinically-driven need for secondary interventions after endovascular revascularization of tibial arteries in patients with critical limb ischemia.临床需求:在重症肢体缺血患者的股腘动脉腔内血管重建后,需要进行二次干预。
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Drug-eluting balloon in peripheral intervention for below the knee angioplasty evaluation (DEBATE-BTK): a randomized trial in diabetic patients with critical limb ischemia.药物涂层球囊在膝下血管成形术评估中的外周介入治疗(DEBATE-BTK):糖尿病合并严重肢体缺血患者的随机试验。
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Infrapopliteal lesion morphology in patients with critical limb ischemia: implications for the development of anti-restenosis technologies.下肢动脉病变形态在临界肢体缺血患者中的意义:对抗再狭窄技术发展的启示。
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A prospective randomized multicenter comparison of balloon angioplasty and infrapopliteal stenting with the sirolimus-eluting stent in patients with ischemic peripheral arterial disease: 1-year results from the ACHILLES trial.前瞻性随机多中心比较球囊血管成形术和雷帕霉素洗脱支架在缺血性外周动脉疾病患者中的应用:ACHILLES 试验 1 年结果。
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6
Angiographic restenosis and its clinical impact after infrapopliteal angioplasty.下肢动脉腔内成形术后的血管造影再狭窄及其临床影响。
Eur J Vasc Endovasc Surg. 2012 Oct;44(4):425-31. doi: 10.1016/j.ejvs.2012.07.017. Epub 2012 Aug 28.
7
Sirolimus-eluting stents for treatment of infrapopliteal arteries reduce clinical event rate compared to bare-metal stents: long-term results from a randomized trial.西罗莫司洗脱支架治疗比裸金属支架治疗降低了主肢动脉的临床事件发生率:随机试验的长期结果。
J Am Coll Cardiol. 2012 Aug 14;60(7):587-91. doi: 10.1016/j.jacc.2012.04.035.
8
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J Am Coll Cardiol. 2011 Sep 6;58(11):1105-9. doi: 10.1016/j.jacc.2011.05.034.