Markers of Restenosis after Percutaneous Transluminal Balloon Angioplasty in Patients with Critical Limb Ischemia
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Published on: September 22, 2020
Elvira V Sobolevskaya1, Oleg A Shumkov1, Mikhail A Smagin1
1Laboratory of Surgical Lymphology and Lymph-Detoxication, Research Institute of Clinical and Experimental Lymphology-Branch of the Institute of Cytology and Genetics, SB RAS, Novosibirsk 630117, Russia.
Insights
Chronic obliterating arterial lesions in lower extremities, often caused by atherosclerosis, can lead to critical limb ischemia. This review explores restenosis mechanisms and predictors after angioplasty to improve patient outcomes.
Area of Science:
- Vascular Surgery
- Cardiology
- Biomolecular Medicine
Background:
- Chronic obliterating lesions of lower extremity arteries, primarily atherosclerosis, pose significant healthcare challenges.
- Critical limb ischemia, a severe form, increases risks of limb loss and cardiovascular mortality, necessitating revascularization.
- Percutaneous transluminal balloon angioplasty is a minimally invasive revascularization option, but restenosis remains a concern.
Purpose of the Study:
- To review current knowledge on restenosis mechanisms following angioplasty for lower extremity arterial disease.
- To identify potential molecular markers and predictors for early restenosis detection.
- To guide future research for inhibiting restenosis and atherosclerosis progression.
Main Methods:
- Comprehensive literature review of studies on lower extremity artery disease, atherosclerosis, and angioplasty.
- Analysis of mechanisms contributing to post-angioplasty restenosis.
- Identification and synthesis of reported predictors and molecular markers of restenosis.
Main Results:
- Atherosclerosis is the primary cause of lower extremity arterial disease and critical limb ischemia.
- Restenosis after percutaneous transluminal balloon angioplasty is a significant complication.
- Early identification of molecular markers could aid in risk stratification and targeted inhibition strategies.
Conclusions:
- Understanding restenosis mechanisms is crucial for improving outcomes in patients undergoing angioplasty for peripheral artery disease.
- Predictive markers are needed for timely intervention and personalized treatment approaches.
- Further research into molecular targets may offer novel therapeutic strategies against restenosis and atherosclerosis.
Abstract:
Among cardiovascular diseases, chronic obliterating lesions of the arteries of lower extremities, which are one of the important problems of modern healthcare, are distinguished. In most cases, the cause of damage to the arteries of lower extremities is atherosclerosis. The most severe form is chronic ischemia, characterized by pain at rest and ischemic ulcers, ultimately increasing the risk of limb loss and cardiovascular mortality. Therefore, patients with critical limb ischemia need limb revascularization. Percutaneous transluminal balloon angioplasty is one of the least invasive and safe approaches, with advantages for patients with comorbidities. However, after this procedure, restenosis is still possible. Early detection of changes in the composition of some molecules as markers of restenosis will help screen patients at the risk of restenosis, as well as find ways to apply efforts for further directions of inhibition of this process. The purpose of this review is to provide the most important and up-to-date information on the mechanisms of restenosis development, as well as possible predictors of their occurrence. The information collected in this publication may be useful in predicting outcomes after surgical treatment and will also find new ways for the target implication to the mechanisms of development of restenosis and atherosclerosis.
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