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Transpedal Access for the Management of Complex Peripheral Artery Disease

Konstantinos Marmagkiolis1, Partha Sardar, Jihad A Mustapha

  • 1Pepin Heart Institute Florida Hospital, Tampa, Florida, USA. c.marmagiolis@gmail.com.

The Journal of Invasive Cardiology
|December 6, 2017
PubMed

Insights

Transpedal access is a safe and effective technique for managing complex peripheral artery disease (PAD). This method shows a high procedural success rate with manageable complications for critical limb ischemia patients.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Procedures

Background:

  • Critical limb ischemia (CLI) significantly increases the risk of limb loss, cardiovascular events, and mortality.
  • Transpedal access represents a novel and increasingly adopted approach for treating complex peripheral artery disease (PAD).

Purpose of the Study:

  • To systematically evaluate the safety and efficacy of the transpedal access technique in managing complex PAD.
  • To analyze procedural outcomes and complication rates associated with transpedal access.

Main Methods:

  • A comprehensive literature search was conducted on PubMed, covering studies from January 2003 to December 2016.
  • Data extraction included patient demographics, indications for procedures, access sites, target vessels, procedural details, success rates, and complications.

Main Results:

  • The review included 10 studies encompassing 881 patients, with 68.4% undergoing transpedal access for CLI and 29.5% for severe claudication.
  • Angiographic success was achieved in 92.6% of cases, with the most frequent complications being dissection (7.49%), perforation (1.36%), and embolization (1.25%).
  • Ultrasound guidance was used in 57.1% of accesses, primarily targeting the anterior tibial or dorsalis pedis arteries (54.7%).

Conclusions:

  • Transpedal access is demonstrated as a safe and effective strategy for the endovascular management of complex peripheral artery disease.
  • The technique offers a high success rate, making it a viable option for patients with severe PAD, including those with critical limb ischemia.
Abstract

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