Repeat BTK revascularization: when, how and what are the results?

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Endovascular Interventions

Background:

• Increasing prevalence of chronic limb-threatening ischemia (CLTI) due to aging populations and diabetes.
• Below-the-knee (BTK) lesions are common in CLTI, requiring complex revascularization.
• Advances in endovascular techniques and devices have improved short-term outcomes for BTK interventions.

Purpose of the Study:

• To summarize current knowledge on repeat BTK interventions for CLTI.
• To review the indications, available options, and outcomes of repeat BTK procedures.
• To present data on repeat interventions in complex peripheral arterial occlusive disease.

Main Methods:

• Limited literature review of MEDLINE, EMBASE, and conference proceedings.
• Keywords included "angioplasty," "endovascular intervention," "infrapopliteal," "tibial arteries," and "below the knee."
• Search focused on English-language publications from 2000 to 2020.

Main Results:

• High rates of re-stenosis and re-occlusion are observed after initial infrapopliteal interventions.
• These high rates limit the long-term success of primary procedures.
• Frequent repeat interventions are often necessary to maintain patency and limb salvage.

Conclusions:

• Repeat BTK interventions are crucial for managing CLTI patients with recurrent disease.
• Understanding the need, options, and outcomes of repeat procedures is essential for optimizing patient care.
• Further research and data presentation are needed to refine strategies for repeat BTK interventions.