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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...
Peripheral Artery Disease IV: Nursing Management01:26

Peripheral Artery Disease IV: Nursing Management

The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses, temperature changes,...
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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...
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...
Atherosclerosis II: Clinical Manifestations and Diagnostic Tests01:27

Atherosclerosis II: Clinical Manifestations and Diagnostic Tests

Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...

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Related Experiment Video

Updated: May 26, 2026

Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound
13:48

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

Published on: April 21, 2023

Advanced Needle-Based Strategies for Complex Calcified Peripheral Artery Disease: A Systematic Review.

Rendra Mahardhika Putra1,2, Suci Indriani3, Johanes Nugroho Eko Putranto1,4

  • 1Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.

Journal of the Society for Cardiovascular Angiography & Interventions
|May 25, 2026
PubMed
Summary
This summary is machine-generated.

Needle-based plaque modification offers a viable solution for complex, calcified peripheral artery disease (PAD) when conventional methods fail. These techniques demonstrate high success rates and durable outcomes, especially in resource-limited environments.

Keywords:
angioplastycomplex lesionsendovascular interventionsperipheral arterial diseasevascular calcification

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Published on: May 15, 2020

Area of Science:

  • Cardiovascular Interventions
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Severely calcified peripheral artery disease (PAD) lesions present significant therapeutic challenges, particularly when conventional balloon angioplasty and atherectomy devices are unavailable.
  • Needle-based plaque modification strategies have emerged as crucial adjunctive or bailout options for complex PAD cases.

Purpose of the Study:

  • To systematically review the efficacy and safety of needle-based plaque-modifying strategies for treating heavily calcified PAD lesions.
  • To evaluate various needle-based techniques, including fracking, PIERCE, BAMBOO SPEAR, biopsy forceps extraction, and FRAP-CROSS.

Main Methods:

  • A systematic review was conducted following PRISMA 2020 guidelines.
  • Searched scientific databases for studies on needle-based interventions in heavily calcified PAD.
  • Included 15 studies with 101 patients, analyzing diverse lesion locations and techniques.

Main Results:

  • Technical success rates ranged from 94% to 100% across various needle-based techniques.
  • Fracking demonstrated significant luminal area gains and favorable 12-month patency (90%) and target lesion revascularization-free survival (94%).
  • Techniques like PIERCE, BAMBOO SPEAR, and FRAP-CROSS showed safety, effectiveness in plaque modification, and comparable long-term durability to atherectomy.

Conclusions:

  • Needle-based plaque modification is a feasible approach for complex calcified PAD, especially in resource-limited settings.
  • These strategies offer effective lesion crossing and vessel expansion.
  • Further prospective research is needed to optimize indications, standardize techniques, and confirm long-term outcomes.