Name:
Publisher version
View Source
Access full-text PDFOpen Access
View Source
Check access options
Check access options
Authors
Keeling, Aoife NKhalidi, Karim
Leong, Sum
Given, Mark F
McGrath, Frank P
Athanasiou, Thanos
Lee, Michael J
Affiliation
Department of Academic Radiology, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland.Issue Date
2009-08MeSH
AgedAged, 80 and over
Angioplasty
Female
Humans
Intermittent Claudication
Ischemia
Leg
Longitudinal Studies
Male
Middle Aged
Peripheral Vascular Diseases
Treatment Outcome
Metadata
Show full item recordCitation
Subintimal angioplasty: predictors of long-term success. 2009, 20 (8):1013-22 J Vasc Interv RadiolJournal
Journal of vascular and interventional radiology : JVIRDOI
10.1016/j.jvir.2009.05.005PubMed ID
19647180Abstract
To determine the clinical outcomes and success rates after percutaneous subintimal angioplasty (SIA) in patients with lower-limb occlusive lesions causing intermittent claudication (IC) or critical limb ischemia (CLI) at midterm to long-term follow-up. The secondary aim was to elicit factors predictive of a successful outcome.Between January 1999 and June 2006, 75 consecutive patients (45 men; age range, 46-91 years; CLI in 79%) underwent SIA of iliac and infrainguinal (84%) occlusions. Outcomes were determined on an intent-to-treat basis. The composite endpoint of interest was major adverse clinical outcome (MACO) of the treated limb at follow-up, which was defined as the development of IC, CLI, or need for subsequent endovascular or surgical revascularization. Actuarial freedom from MACO was assessed via Kaplan-Meier curves and multivariable Cox proportional-hazards regression.
SIA was performed on 75 lesions, with an initial procedure success rate of 83% (n = 62). Procedure failure was caused by heavily calcified lesions (n = 5) and failure of reentry (n = 8). A total of 56.3% of patients with claudication were free from ipsilateral claudication at follow-up (mean, 32 months; range, 1-64 months), and those with CLI had a 79.7% limb salvage rate at a mean follow-up of 30.7 months (range, 0.5-91 months). On Cox regression analysis, the following variables were identified as independent predictors of MACO within the limb treated with SIA: ABI after SIA (hazard ratio, 0.21; 95% CI, 0.05-0.89; P = .035) and number of patent runoff vessels (ie, /=2; hazard ratio, 0.29; 95% CI, 0.15-0.59; P = .001).
SIA is a feasible therapeutic option for occlusive atherosclerotic lesions in IC and CLI and is the evolving preferred strategy in CLI and perhaps IC with long-segment occlusions.
Item Type
ArticleLanguage
enISSN
1535-7732ae974a485f413a2113503eed53cd6c53
10.1016/j.jvir.2009.05.005
Scopus Count
Collections
Related articles
- Should incidental asymptomatic angiographic stenoses and occlusions be treated in patients with peripheral arterial disease?
- Authors: Keeling AN, Naughton PA, Khalidi K, Ayyoub AS, Kelly CK, Leahy AL, Bouchier-Hayes DJ, Athanasiou T, Lee MJ
- Issue date: 2009 Sep
- Subintimal angioplasty of infrapopliteal artery occlusions in the treatment of critical limb ischaemia. Short-term results.
- Authors: Tartari S, Zattoni L, Rolma G, Sacco A
- Issue date: 2004 Sep
- Outcomes of reinterventions after subintimal angioplasty.
- Authors: Schmieder GC, Richardson AI, Scott EC, Stokes GK, Meier GH 3rd, Panneton JM
- Issue date: 2010 Aug
- Subintimal angioplasty of chronic total occlusion in iliac arteries: a safe and durable option.
- Authors: Chen BL, Holt HR, Day JD, Stout CL, Stokes GK, Panneton JM
- Issue date: 2011 Feb
- Subintimal angioplasty for the treatment of claudication and critical limb ischemia: 3-year results.
- Authors: Scott EC, Biuckians A, Light RE, Scibelli CD, Milner TP, Meier GH 3rd, Panneton JM
- Issue date: 2007 Nov