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Subintimal angioplasty in lower limb ischaemia
I M Loftus1, P D Hayes, P R F Bell
1Department of Vascular and Endovascular Surgery, Leicester Royal Infirmary, Leicester, UK. ianloftus@aol.com
The Journal of Cardiovascular Surgery
|June 5, 2004
Summary
Subintimal angioplasty is a safe and effective treatment for lower limb occlusive disease, particularly for femoro-popliteal and infra-popliteal arteries. Further trials are needed to confirm its efficacy for iliac disease.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
Background:
- Subintimal angioplasty is a treatment option for occlusive disease.
- Its safety and durability are debated.
- It has reduced operative workload in some centers.
Purpose of the Study:
- To review the evidence for subintimal angioplasty in lower limb occlusive disease.
Main Methods:
- Systematic literature review of Medline search.
Main Results:
- Established technique for lower limb occlusive disease despite limited trial data.
- Excellent results for femoro-popliteal disease (technical/clinical success, low complications).
- Caution advised for iliac disease due to less documented results.
- Safe with good outcomes for infra-popliteal disease in critical ischemia patients.
Conclusions:
- Subintimal angioplasty is a safe and effective treatment for femoro-popliteal and infra-popliteal occlusive disease.
- Requires a learning curve; training at experienced centers recommended.
- Large-scale randomized controlled trials are needed for wider acceptance.