Related Experiment Video

Updated: Oct 12, 2025

Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
07:25

Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia

Published on: September 22, 2020

3.5K

The role of directional atherectomy in critical-limb ischemia

Prakash Krishnan1, Arthur Tarricone2, Simon Chen3

  • 1The Zena and Michael A. Weiner Cardiovascular Institute and the Marie-Josée and Henry R. Kravis Cardiovascular Health Center, Department of Medicine/Cardiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1030, New York, NY 10029, USA.

Therapeutic Advances in Cardiovascular Disease
|November 19, 2021
PubMed

Insights

Directional atherectomy (DA) shows promise for treating lower extremity critical-limb ischemia. This review of eleven papers found promising limb salvage and patency rates, suggesting DA is a valuable tool.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Therapy

Background:

  • Lower extremity critical-limb ischemia (CLI) poses a significant clinical challenge.
  • Effective treatment options for CLI are continuously being investigated.

Purpose of the Study:

  • To review the existing literature on the efficacy of directional atherectomy (DA) for treating CLI.
  • To synthesize data on key outcomes of DA interventions in CLI patients.

Main Methods:

  • A comprehensive literature search was conducted in PubMed and PubMed Central.
  • Eleven relevant papers detailing clinical and procedural data of DA interventions were included.
  • Systematic reviews were excluded to focus on primary research.

Main Results:

  • Included studies reported primary patency rates from 56.3% to 95.0% and secondary patency rates from 76.4% to 100%.
  • Limb salvage rates varied between 69% and 100%, indicating significant potential for limb preservation.
  • The procedure demonstrated technical success across a wide range of lesion lengths, from 30 ± 33 mm to 142.4 ± 107.9 mm.

Conclusions:

  • Directional atherectomy (DA) appears to be a viable and effective therapeutic option for patients suffering from lower extremity critical-limb ischemia.
  • The procedure offers encouraging results in terms of patency and limb salvage, supporting its consideration in CLI management.
Abstract

Keywords:
Critical Limb IschemiaDirectional AtherectomyPeripheral Artery Disease

More Related Videos

Assessing Therapeutic Angiogenesis in a Murine Model of Hindlimb Ischemia07:48

Assessing Therapeutic Angiogenesis in a Murine Model of Hindlimb Ischemia

Published on: June 8, 2019

8.9K
Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound13:48

Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound

Published on: April 21, 2023

1.7K

Related Concept Videos

Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
52
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
63
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
63
Peripheral Artery Disease I: Introduction01:30

Peripheral Artery Disease I: Introduction

Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
68
Atherosclerosis IV: Nursing Management01:23

Atherosclerosis IV: Nursing Management

Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
95
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
51