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Bifurcation stenting after failed angioplasty of infrapopliteal arteries in critical limb ischemia: Techniques and short‐term follow‐up
Author(s) -
Werner Martin,
Scheinert Susanne,
Bausback Yvonne,
Bräunlich Sven,
Ulrich Matthias,
Piorkowski Michael,
Scheinert Dierk,
Schmidt Andrej
Publication year - 2013
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.24828
Subject(s) - medicine , critical limb ischemia , angioplasty , ankle , balloon , radiology , stent , cardiology , surgery , vascular disease , arterial disease
Objectives To report on the efficacy of drug eluting stents (DES) in below the knee lesions involving arterial bifurcations after failed angioplasty. Background DES have become a mainstay in the treatment of below the knee lesions. However, little is known about the efficacy of DES in infapopliteal lesions involving the arterial bifurcations. This is the first report on the endovascular treatment of below‐the knee bifurcations. Methods 11 patients with critical lower limb ischemia and complex infrapopliteal atherosclerotic disease underwent provisional DES placement in infrapopliteal bifurcation lesions. Clinical and angiographic follow–up data were prospectively collected in all patients. Results Technical success was achieved in all cases. After 6 months, the two vessel primary patency (2VPP) rate was 54.5% and the 1VPP rate was 81.8%. Between baseline and the follow‐up, mean ankle‐brachial index increased from 0.31 ± 0.10 to 0.68 ± 0.16, and mean Rutherford–Becker class decreased from 4.73 ± 0.20 to 3.00 ± 1.41 ( P < 0.001 for both comparisons). Conclusions Bifurcation stenting techniques, that are described for the coronary arteries can be also performed in the infrapopliteal arteries. However, early reocclusion was frequent in this case series, when stenting was performed in a bail‐out setting. If balloon angioplasty alone leads to no sufficient results in bifurcation lesions, a single stent strategy could also be considered. © 2013 Wiley Periodicals, Inc.