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Related Concept Videos

Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

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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...
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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...
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Related Experiment Video

Updated: Aug 9, 2025

Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound
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Crossing Algorithm for Infrainguinal Chronic Total Occlusions: An Interdisciplinary Expert Opinion Statement.

Grigorios Korosoglou1, Andrej Schmidt2, Michael Lichtenberg3

  • 1GRN Hospital Weinheim, Cardiology and Vascular Medicine, Weinheim, Germany.

JACC. Cardiovascular Interventions
|February 15, 2023
PubMed
Summary

A new algorithm standardizes endovascular treatment for peripheral chronic total occlusions (CTOs). This approach guides clinicians through imaging, wiring, and advanced techniques for improved patient outcomes.

Keywords:
antegrade/retrograde crossingduplex sonographyendovascular repairguidewires (GWs)infrainguinalintravascular ultrasoundperipheral chronic total occlusions (CTO)re-entry catheter devicestreatment algorithm

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Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Procedures

Background:

  • Peripheral chronic total occlusions (CTOs) present significant challenges in endovascular treatment.
  • Current endovascular procedures for CTOs lack standardization, potentially impacting outcomes.

Purpose of the Study:

  • To introduce a novel crossing algorithm for the endovascular treatment of peripheral CTOs.
  • To standardize and harmonize endovascular procedures for CTOs, improving clinical practice.

Main Methods:

  • The algorithm involves detailed pre-procedural imaging (duplex sonography, CT/MR angiography) for access site selection.
  • It includes comprehensive angiographic evaluation of lesion morphology, collaterals, and distal vessel quality.
  • Strategies encompass antegrade and retrograde wiring, advanced bidirectional techniques, and re-entry devices.

Main Results:

  • The algorithm outlines a systematic approach from access site selection to guidewire (GW) passage and externalization.
  • It details criteria for stopping antegrade attempts and managing retrograde access.
  • The proposed method includes advanced techniques and decision-making for complex CTO cases.

Conclusions:

  • Implementation of this algorithm is expected to improve vessel- and patient-specific outcomes in endovascular CTO treatment.
  • The study emphasizes the need for continuous collaboration and future research among endovascular specialists.