Retrograde tibial access for revascularization of chronic total occlusions in patients with chronic limb-threatening ischemia

被引:0
|
作者
Raskin, Daniel [1 ]
Barash, Yiftach [1 ]
Silverberg, Daniel [2 ]
Halak, Moshe [2 ]
Hater, Hatem [2 ]
Khaitovich, Boris [1 ]
机构
[1] Tel Aviv Univ, Sheba Med Ctr, Div Diagnost Imaging, Sackler Sch Med, IL-52621 Tel Aviv, Israel
[2] Tel Aviv Univ, Sheba Med Ctr, Sackler Sch Med, Dept Vasc Surg, Tel Aviv, Israel
关键词
Peripheral artery; single access; tibial anterior artery; endovascular therapy; chronic total occlusion; chronic limb-threatening ischemia; TRANSPEDAL APPROACH; PEDAL ACCESS;
D O I
10.1177/17085381231192691
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Purpose To evaluate tibial single access in treatment of chronic total occlusions (CTO) in patients with ipsilateral chronic-limb ischemia (CLTI). Materials and Methods In this retrospective study, data was collected on patients treated for ipsilateral CTO via a tibial artery access between March 2017 and March 2021. Fifty-nine limbs in 57 patients, (42 men, average age 73 years; range 47-96) were treated. Patient's symptoms were classified in accordance with the Rutherford category. The end points were freedom from major amputation and the need for reintervention up to 1 year of follow up. Results Out of the 59 treated limbs, technical success was achieved in 57 (97%). The treated multilevel segments involved 5 common and 12 external iliac arteries, 23 common and 37 superficial femoral arteries, 23 femoropopliteal segments, 14 popliteal arteries, and 4 bypasses. Mean length of occlusion was 186 mm (range 7-670). Rutherford classification of the treated limbs was category 5 and 6 in 45 patients and category 4 in 14 patients. Three procedural complications occurred and were successfully treated during the same procedure. No immediate post-procedural complication was encountered. Median follow-up was 13 months (range 1-45.3). Reintervention was required in 9 limbs, after an average of 6 months. One year free from amputation rate was 91.2%. Conclusions Single access via the ipsilateral tibial artery can be a useful, effective, and safe approach for treating CTO in CLTI patients.
引用
收藏
页码:1220 / 1225
页数:6
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