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Subintimal angioplasty in lower limb ischaemia
1Department of Radiology, Leicester Royal Infirmary NHS Trust, Leicester, UK. amman.bolia@uhl-tr.nhs.uk
The Journal of Cardiovascular Surgery
|September 15, 2005
Summary
Subintimal angioplasty is a valuable treatment for peripheral artery disease, effectively managing intermittent claudication and critical limb ischemia. This technique shows high success and limb salvage rates, making it a cost-effective option.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Peripheral Artery Disease
Background:
- Subintimal angioplasty has evolved over 18 years, gaining recent popularity due to European and US publications.
- Initially successful in the femoropopliteal segment, the technique has been extended to infrapopliteal interventions.
Purpose of the Study:
- To evaluate the efficacy of subintimal angioplasty in treating peripheral artery disease, specifically intermittent claudication and critical limb ischemia.
- To assess the technique's applicability in femoropopliteal and infrapopliteal segments, including tibial occlusions and trifurcation reconstitution.
Main Methods:
- Review of publications and clinical outcomes related to subintimal angioplasty.
- Application of the technique to femoropopliteal and infrapopliteal arterial segments.
Main Results:
- Primary success rates of 80-90% in infrainguinal and infrapopliteal segments.
- Reported 5-year patency rates of 64% in the superficial femoral artery for claudication.
- High limb salvage rates of 85-90% at 1 year for critical limb ischemia.
Conclusions:
- Subintimal angioplasty is a useful and inexpensive treatment for intermittent claudication.
- The technique is highly effective for critical limb ischemia, offering significant limb salvage benefits.