Duplex-guided balloon angioplasty and stenting for femoropopliteal arterial occlusive disease: an alternative in patients with renal insufficiency.

Abstract:

BACKGROUND:The technique of balloon angioplasty of infrainguinal arteries requires standard arteriography and fluoroscopic guidance. We attempted to perform this procedure under duplex guidance to avoid the use of nephrotoxic contrast material and radiation exposure in patients with renal insufficiency. METHODS:Over 16 months, 28 patients (17 men) with serum creatinine levels of 1.5 mg/dL or more underwent 37 lower extremity duplex-guided balloon angioplasties at our institution. Ages ranged from 58 to 92 years (mean +/- SD, 74 +/- 9 years). Disabling claudication was the indication in 24 cases (65%), and critical ischemia, in 13 cases. Preoperative duplex arterial mapping showed severe superficial femoral artery and/or popliteal artery stenoses in all cases. No arterial occlusions were treated in this series. Seven procedures (19%) were performed for restenosis. The ipsilateral common femoral artery was cannulated in 32 cases (86%), and the contralateral common femoral artery, in 5 cases (14%), under direct duplex visualization. Contralateral common iliac artery cannulations were performed with the help of fluoroscopy. By using sonographic visualization, a guidewire was directed into the origin of the superficial femoral artery, across the diseased segment, and into the popliteal artery. The diseased segment was then balloon-dilated. Balloon diameter and length were chosen according to arterial measurements obtained by duplex scan. Plaque dissections and recoils causing stenosis of 30% or more, a peak systolic velocity ratio of 2 or more, or both were stented under duplex guidance. Arterial duplex examinations and ankle/brachial indexes were obtained before hospital discharge, within 1 month after the procedure, and every 3 months thereafter. RESULTS:Thirty-day survival was 100%. Local complications included one open exploration for expanding hematoma. Technical success was achieved in all cases. Placement of intraluminal stents was deemed appropriate in 23 (62%) of 37 cases. The 1-month patency and limb salvage rates were 100%. Preprocedure and postprocedure ankle/brachial indexes ranged from 0.3 to 0.9 (mean +/- SD, 0.64 +/- 0.16) and 0.64 to 1.2 (mean +/- SD, 0.92 +/- 0.15), respectively (P < .0001). CONCLUSIONS:Duplex-guided balloon angioplasty seems to be a safe and effective technique that allows renal patients to experience continued limb salvage and relief from claudication without the risk of developing dye-induced acute renal failure. Other advantages include direct visualization of the puncture site, accurate selection of the proper size of balloon and stent, confirmation of the adequacy of the technique by hemodynamic and imaging parameters, and avoidance of radiation. Although this technique holds considerable potential, longer follow-up will help to fully evaluate its broader applicability.

journal_name

J Vasc Surg

authors

Ascher E,Marks NA,Schutzer RW,Hingorani AP

doi

10.1016/j.jvs.2005.08.024

subject

Has Abstract

pub_date

2005-12-01 00:00:00

pages

1108-13

issue

6

eissn

0741-5214

issn

1097-6809

pii

S0741-5214(05)01286-3

journal_volume

42

pub_type

杂志文章
  • Bovine carotid artery biologic graft outperforms expanded polytetrafluoroethylene for hemodialysis access.

    abstract:OBJECTIVE:Arteriovenous grafts remain reliable substitutes for permanent hemodialysis access in patients without a suitable autogenous conduit. Advances in conduit design and endovascular management of access-related complications question the preference for synthetic conduits over biologic grafts in contemporary pract...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2016.10.080

    authors: Arhuidese I,Reifsnyder T,Islam T,Karim O,Nejim B,Obeid T,Qazi U,Malas M

    更新日期:2017-03-01 00:00:00

  • Aneurysmal degeneration of type B aortic dissections after thoracic endovascular aortic repair: A systematic review.

    abstract:BACKGROUND:Promising results of thoracic endovascular aortic repair (TEVAR) in patients with complicated type B aortic dissection (TBAD) have been well documented. However, whereas early results have led many to hypothesize a benefit of TEVAR in uncomplicated patients, the natural history of TEVAR after the treatment o...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章,评审

    doi:10.1016/j.jvs.2017.06.067

    authors: Famularo M,Meyermann K,Lombardi JV

    更新日期:2017-09-01 00:00:00

  • Late results of iliofemoral venous thrombectomy.

    abstract:PURPOSE:Although anticoagulation therapy for iliofemoral venous thrombosis prevents pulmonary embolism, it is not designed to avoid the postthrombotic syndrome. Mechanical removal of the thrombus in the form of venous thrombectomy should yield better long-term results. The purpose of our study was to analyze the clinic...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/s0741-5214(97)70249-0

    authors: Juhan CM,Alimi YS,Barthelemy PJ,Fabre DF,Riviere CS

    更新日期:1997-03-01 00:00:00

  • Mortality rates and walking ability transition after lower limb major amputation in hemodialysis patients.

    abstract:OBJECTIVE:The number of hemodialysis patients with peripheral artery disease is increasing, and critical limb ischemia develops in some of these patients. The clinical outcomes in such patients after major amputation remain unclear. We therefore examined the mortality rates after major amputation in hemodialysis patien...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2016.03.452

    authors: Serizawa F,Sasaki S,Fujishima S,Akamatsu D,Goto H,Amada N

    更新日期:2016-10-01 00:00:00

  • Current indications for axillounifemoral and axillobifemoral bypass grafts.

    abstract::Revascularization of the lower extremities may require an axillofemoral bypass when an aortobifemoral bypass is contraindicated. Thirty-one patients underwent axillounifemoral and 59 had an axillobifemoral bypass, with a mortality rate of 9%. The indication for operation was limb salvage in 67%, intra-abdominal sepsis...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:

    authors: Kalman PG,Hosang M,Cina C,Johnston KW,Ameli FM,Walker PM,Provan JL

    更新日期:1987-06-01 00:00:00

  • National trends in venous disease.

    abstract:BACKGROUND:The national burden of venous disease and use of ultrasound (US) in the outpatient and emergency department (ED) settings has not been well described. The objective of this study is to describe venous disease in the outpatient and ED settings nationally as well as to characterize the use of US for diagnosis ...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2009.12.070

    authors: Barnes GD,Gafoor S,Wakefield T,Upchurch GR Jr,Henke P,Froehlich JB

    更新日期:2010-06-01 00:00:00

  • Pre-emptive nonselective perigraft aortic sac embolization with coils to prevent type II endoleak after endovascular aneurysm repair.

    abstract:OBJECTIVE:Pre-emptive selective embolization of inferior mesenteric artery (IMA), lumbar arteries (LAs), and perigraft sac for prevention of type II endoleak (T2EL) has not been widely adopted. We perform pre-emptive nonselective perigraft aortic sac embolization with coils (PNPASEC) in patients at high risk for develo...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2018.10.054

    authors: Dosluoglu HH,Rivero M,Khan SZ,Cherr GS,Harris LM,Dryjski ML

    更新日期:2019-06-01 00:00:00

  • Correlation of venous noninvasive tests with the Society for Vascular Surgery/International Society for Cardiovascular Surgery clinical classification of chronic venous insufficiency.

    abstract:PURPOSE:Noninvasive tests for the evaluation of chronic venous insufficiency (CVI) include quantitative photoplethysmography (QPG), air plethysmography, and duplex ultrasonography measurement of valve closure time (VCT). These tests have been shown to accurately identify the presence of CVI, define the disease, and loc...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/s0741-5214(94)70211-x

    authors: Iafrati MD,Welch H,O'Donnell TF,Belkin M,Umphrey S,McLaughlin R

    更新日期:1994-06-01 00:00:00

  • Effect of contralateral severe stenosis or carotid occlusion on duplex criteria of ipsilateral stenoses: comparative study of various duplex parameters.

    abstract:PURPOSE:This study compares the accuracy of various duplex parameters in grading ipsilateral carotid stenoses in patients with contralateral severe stenoses or occlusion. METHODS:Four duplex criteria were correlated to arteriography in 356 carotid arteries in blind fashion: (1) standard criteria: a peak systolic frequ...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/s0741-5214(95)70066-8

    authors: AbuRahma AF,Richmond BK,Robinson PA,Khan S,Pollack JA,Alberts S

    更新日期:1995-12-01 00:00:00

  • Renal failure after embolization of a prosthetic mitral valve disc and review of systemic disc embolization.

    abstract::Embolization of discs from various prosthetic mitral valves produces fulminant cardiac failure with possible survival after emergent mitral valve prosthetic replacement. The embolized discs lodge in the aorta at various levels parallel to the blood stream and have not occluded distal flow. Some embolized discs have be...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:

    authors: Schwarcz TH,Coffin LH,Pilcher DB

    更新日期:1985-09-01 00:00:00

  • Virtual reality simulation objectively differentiates level of carotid stent experience in experienced interventionalists.

    abstract:OBJECTIVES:Technical proficiency in carotid artery stent (CAS) procedures is paramount to ensure patient safety. If virtual reality (VR) simulation is to be used as a valid means for credentialing physicians for CAS procedures, the assessment parameters must be able to evaluate the performance during CAS and to differe...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2007.06.028

    authors: Van Herzeele I,Aggarwal R,Choong A,Brightwell R,Vermassen FE,Cheshire NJ

    更新日期:2007-11-01 00:00:00

  • Carotid endarterectomy in patients less than 50 years old.

    abstract:PURPOSE:The purpose of this study was to compare the results of carotid endarterectomy (CEA) in a young population with premature atherosclerosis with the results of an older control group, examining perioperative morbidity and mortality data, recurrent stenosis and symptoms, late stroke, and survival data. METHODS:We...

    journal_title:Journal of vascular surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0741-5214(97)70037-5

    authors: Martin GH,Allen RC,Noel BL,Talkington CM,Garrett WV,Smith BL,Pearl GJ,Thompson JE

    更新日期:1997-09-01 00:00:00

  • DNA-array of gene variants in venous leg ulcers: detection of prognostic indicators.

    abstract:OBJECTIVE:Wound healing in venous leg ulcer (VLU) is a multi-step process involving complex pathways. Scanty knowledge at molecular level hinders clinical assessment and treatment. Anomalous handling of local iron overload, as well as unbalancing in matrix metalloproteinases (MMPs) and transglutaminase, has a recognize...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2009.07.103

    authors: Gemmati D,Federici F,Catozzi L,Gianesini S,Tacconi G,Scapoli GL,Zamboni P

    更新日期:2009-12-01 00:00:00

  • Outcome of endovascular repair of popliteal artery aneurysm using the Viabahn endoprosthesis.

    abstract:OBJECTIVE:This study reviews a single-center experience of endovascular popliteal aneurysm (PAA) repair. METHODS:A retrospective review was performed to identify all endovascular PAA repairs performed between September 2004 and January 2011. RESULTS:We identified 21 patients (mean age, 74 ± 9 years, 91% men) with PAA...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2011.12.059

    authors: Garg K,Rockman CB,Kim BJ,Jacobowitz GR,Maldonado TS,Adelman MA,Veith FJ,Cayne NS

    更新日期:2012-06-01 00:00:00

  • Endovascular treatment as first line approach for infrarenal aortic occlusive disease.

    abstract:INTRODUCTION:The purpose of this study was to report the early and late results of primary stenting for focal atherosclerotic lesions of the infrarenal aorta. METHODS:A retrospective analysis of 52 consecutive patients treated for infrarenal occlusive aortic disease with primary stenting between January 2002 and Novem...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2011.02.007

    authors: Schwindt AG,Panuccio G,Donas KP,Ferretto L,Austermann M,Torsello G

    更新日期:2011-06-01 00:00:00

  • Atherosclerotic aortic lesions increase the risk of cerebral embolism during carotid stenting in patients with complex aortic arch anatomy.

    abstract:BACKGROUND:Carotid artery stenting (CAS) leads to frequent embolic brain lesions; their source has not been clearly identified yet. In order to investigate this phenomenon, we have evaluated embolic brain lesions (BL) after CAS and correlated them with aortic arch (AA) characteristics. METHODS:The AAs of 59 patients u...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2008.08.014

    authors: Faggioli G,Ferri M,Rapezzi C,Tonon C,Manzoli L,Stella A

    更新日期:2009-01-01 00:00:00

  • The ethics of insurance limiting institutional medical care: It's all about the money.

    abstract::Dr F. Inest practices surgery at a renowned medical center but is concerned because increasing numbers of medical insurers are excluding his institution from coverage. Many of his former referring physicians are beginning to send their patients elsewhere for this reason. The marketing people have been busy increasing ...

    journal_title:Journal of vascular surgery

    pub_type: 社论

    doi:10.1016/j.jvs.2016.02.001

    authors: Jones JW,McCullough LB

    更新日期:2016-04-01 00:00:00

  • Cystic adventitial disease of the femoral vein presenting as deep vein thrombosis: a case report and review of the literature.

    abstract::Cystic adventitial disease of veins is a rare condition. We report the case of a 28-year-old man who presented with a swollen leg secondary to obstruction of the common femoral vein as a result of this disease. He underwent excision of the cyst and made a full recovery. The presentation, investigation, treatment and p...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2006.05.034

    authors: Dix FP,McDonald M,Obomighie J,Chalmers N,Thompson D,Benbow EW,Smyth JV

    更新日期:2006-10-01 00:00:00

  • Multicenter prospective study of nonruptured abdominal aortic aneurysm. Part II. Variables predicting morbidity and mortality.

    abstract::A previous article (Part I) described the patient population and operative management of 666 patients who had surgery for nonruptured abdominal aortic aneurysms. This article details the perioperative complications and, by chi-square and logistic regression analysis, identifies the variables that are associated with e...

    journal_title:Journal of vascular surgery

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1067/mva.1989.vs0090437

    authors: Johnston KW

    更新日期:1989-03-01 00:00:00

  • Compound polyglactin 910/polypropylene small vessel prostheses.

    abstract::This study evaluated morphologic and functional characteristics of tissue reactions to compound prostheses of 69% absorbable polyglactin 910 (PG910) and 31% nonabsorbable polypropylene in the rabbit. Forty-two woven PG910/polypropylene prostheses (24 X 4 mm internal diameter) implanted into rabbit infrarenal aortas we...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1067/mva.1987.avs0050572

    authors: Greisler HP,Kim DU,Dennis JW,Klosak JJ,Widerborg KA,Endean ED,Raymond RM,Ellinger J

    更新日期:1987-04-01 00:00:00

  • Exercise training for intermittent claudication.

    abstract:OBJECTIVE:The objective of this study was to provide an overview of evidence regarding exercise therapies for patients with lower extremity peripheral artery disease (PAD). METHODS:This manuscript summarizes the content of a lecture delivered as part of the 2016 Crawford Critical Issues Symposium. RESULTS:Multiple ra...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章,meta分析,评审

    doi:10.1016/j.jvs.2017.05.111

    authors: McDermott MM

    更新日期:2017-11-01 00:00:00

  • Outcomes of endovascular aneurysm repair performed in abdominal aortic aneurysms with large infrarenal necks.

    abstract:OBJECTIVE:The aim of this study was to evaluate midterm clinical and morphologic outcomes after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA) with large (≥28 mm) infrarenal neck. METHODS:From 2009 to 2012, we prospectively collected and retrospectively analyzed clinical, morphologic, and intra...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.jvs.2017.01.066

    authors: Gargiulo M,Gallitto E,Wattez H,Verzini F,Bianchini Massoni C,Loschi D,Freyrie A,Haulon S

    更新日期:2017-10-01 00:00:00

  • Increased hospital costs are associated with low skeletal muscle mass in patients undergoing elective open aortic surgery.

    abstract:OBJECTIVE:Low psoas muscle area is shown to be an indicator for worse postoperative outcome in patients undergoing vascular surgical. Additionally, it has been associated with longer durations of hospital stay in patients with cancer who undergo surgery and subsequently greater health care costs in Europe and the Unite...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2018.06.224

    authors: Koter S,Cohnert TU,Hindermayr KB,Lindenmann J,Brückner M,Oswald WK,Werkgartner G,Wagner D

    更新日期:2019-04-01 00:00:00

  • Obtaining a superficial femoral artery graft in adolescents and children with the deep femoral artery transposition.

    abstract::A new technique to obtain a segment of the superficial femoral artery as an arterial conduit in young patients while an unobstructed peripheral blood flow is maintained by superficial femoral artery-deep femoral artery transposition is illustrated with two clinical examples. The explanted arterial autograft requires n...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1067/mva.2001.109762

    authors: Bednarkiewicz M,Vala D,Khatchourian G,Kadry Z,Morel P,Christenson JT,Faidutti B

    更新日期:2001-02-01 00:00:00

  • Persistent platelet activation by passivated grafts.

    abstract::Vascular grafts in canines exhibit similar healing patterns to humans in that the graft surface forms a pseudointima over time but endothelializes only near the anastomotic sites. Thus the pseudointima at the midportion of the graft may represent a nidus for persistent platelet activation. The purpose of this investig...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:

    authors: Ito RK,Brophy CM,Contreras MA,Tsoukas A,LoGerfo FW

    更新日期:1991-06-01 00:00:00

  • Use of completion imaging during infrainguinal bypass in the Vascular Quality Initiative.

    abstract:OBJECTIVE:The purpose of this study was to examine the practice patterns of intraoperative completion imaging (CI) for lower extremity bypass (LEB) in the Vascular Quality Initiative (VQI). METHODS:A retrospective review of all LEB procedures in the VQI database from January 2003 to October 2013 was performed. Regions...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2014.12.046

    authors: Woo K,Palmer OP,Weaver FA,Rowe VL,Society for Vascular Surgery Vascular Quality Initiative.

    更新日期:2015-05-01 00:00:00

  • Percutaneous transluminal angioplasty results in improved physical function but not balance in patients with intermittent claudication.

    abstract:OBJECTIVE:The aim of this study was to identify whether revascularization by percutaneous transluminal angioplasty (PTA) for patients with intermittent claudication improved measures of functional performance including balance. METHODS:A prospective observational study was performed at a single tertiary vascular cente...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2013.05.106

    authors: Gohil RA,Mockford KA,Mazari FA,Khan JA,Van Vanicek N,Chetter IC,Coughlin PA

    更新日期:2013-12-01 00:00:00

  • Higher surgeon annual volume, but not years of experience, is associated with reduced rates of postoperative complications and reoperations after open abdominal aortic aneurysm repair.

    abstract:OBJECTIVE:Volume-outcome relationships for open abdominal aortic aneurysm (AAA) repair have received less attention in publicly funded health systems. Furthermore, the roles of surgeon seniority (years of experience) and composite volume (encompassing all major arterial cases) on outcomes after open AAA repair are less...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章

    doi:10.1016/j.jvs.2017.10.050

    authors: Dubois L,Allen B,Bray-Jenkyn K,Power AH,DeRose G,Forbes TL,Duncan A,Shariff SZ

    更新日期:2018-06-01 00:00:00

  • Thrombolysis for early failure of prosthetic arteriovenous access.

    abstract:BACKGROUND:Early failure (within 6 weeks of construction) of prosthetic arteriovenous access (AVA) is traditionally treated by surgical revision rather than endovascular intervention because it is assumed to be related to technical factors related to the surgery. This premise is not evidence based and our results for s...

    journal_title:Journal of vascular surgery

    pub_type: 临床试验,杂志文章

    doi:10.1016/j.jvs.2007.10.047

    authors: Shemesh D,Goldin I,Berelowitz D,Zaghal I,Olsha O

    更新日期:2008-03-01 00:00:00

  • Carotid body tumor: atypical angiogram of a functional tumor.

    abstract::Carotid body tumors (CBTs) are rare, usually benign, neoplasms of the extra-adrenal paraganglion system. They are almost always nonfunctional. The diagnosis is generally confirmed by an angiogram that shows a vascular tumor enlarging the space between the internal and external carotid arteries. A 55-year-old man with ...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章,评审

    doi:

    authors: MacGillivray DC,Perry MO,Selfe RW,Nydick I

    更新日期:1987-03-01 00:00:00