کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5996092 1179883 2010 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Subintimal angioplasty for femoro-popliteal occlusive disease
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Subintimal angioplasty for femoro-popliteal occlusive disease
چکیده انگلیسی

There has been a longstanding debate about the roles of surgical bypass graft, percutaneous transluminal angioplasty, subintimal angioplasty, and conservative management for femoro-popliteal occlusive disease. Subintimal angioplasty was first described in 1987 as a method of performing an endovascular arterial bypass. The subintimal space at the start of the occlusion is entered with a catheter and a wire loop is used to cross the occlusion and reenter the vessel lumen distally. In patients with critical limb ischemia, there is high quality evidence demonstrating that the limb salvage rate and amputation-free survival rates for surgery and endovascular treatment are similar, but surgery is more expensive than angioplasty in the short term. In patients with intermittent claudication, surgical bypass using an autologous saphenous vein graft is currently believed to be the gold standard, but this is increasingly questioned in the light of recent advances in endovascular techniques. Surgical bypass with vein graft offers a 2-year patency of 81%, compared with 67% for a polytetrafluoroethylene (PTFE) graft and at best 67% for subintimal angioplasty. The better patency offered by surgery must be balanced against a higher morbidity and mortality. To conclude, subintimal angioplasty is an extremely valuable technique in the management of critical limb ischemia. Based on the evidence to date, this technique is likely to have an increasing role in the management of intermittent claudication over the coming years, particularly if the risk of general anaesthesia is high or there is no suitable vein.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Vascular Surgery - Volume 52, Issue 5, November 2010, Pages 1410-1416
نویسندگان
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