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Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication
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Surgical and Endovascular Therapies for Below-the-Knee Peripheral Arterial Disease: A Contemporary Review

Robert S Zilinyi1, Marissa Alsaloum2, Daniel J Snyder2

  • 1Division of Cardiology, Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York.

Journal of the Society for Cardiovascular Angiography & Interventions
|August 12, 2024
PubMed

Insights

Peripheral arterial disease (PAD) is a common cardiovascular issue. This review covers revascularization for below-the-knee PAD, focusing on endovascular techniques and emerging devices for chronic limb-threatening ischemia.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Peripheral arterial disease (PAD) is a widespread cardiovascular condition associated with significant morbidity and mortality.
  • Chronic limb-threatening ischemia (CLTI), the most severe form of PAD, particularly affects patients with below-the-knee (BTK) PAD.
  • BTK PAD patients face higher CLTI risks due to small vessel size and common comorbidities like diabetes and end-stage renal disease.

Purpose of the Study:

  • To review modern surgical and endovascular revascularization strategies for BTK PAD.
  • To discuss current and emerging devices for treating CLTI in BTK PAD patients.
  • To provide an overview of the standard of care evolution in BTK PAD management.

Main Methods:

  • Review of current literature on surgical and endovascular revascularization for BTK PAD.
  • Analysis of the evolution of treatment modalities from surgical bypass to endovascular techniques.
  • Examination of adjunctive devices and therapies used in modern endovascular interventions.

Main Results:

  • Endovascular techniques have become the standard of care for most CLTI cases in BTK PAD.
  • Surgical bypass was the historical standard but is now complemented by less invasive endovascular approaches.
  • A range of devices and therapies enhance the efficacy of endovascular revascularization.

Conclusions:

  • Endovascular revascularization represents a significant advancement in managing BTK PAD with CLTI.
  • Ongoing development of new devices promises further improvements in treatment outcomes.
  • Comprehensive understanding of both surgical and endovascular options is crucial for optimal patient care.

Keywords:
below-the-kneechronic limb-threatening ischemiaperipheral artery disease

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