Journal ArticleDOI
Limb Salvage following Laser-Assisted Angioplasty for Critical Limb Ischemia: Results of the LACI Multicenter Trial
John R. Laird,Thomas Zeller,Bruce H Gray,Dierk Scheinert,Mitar Vranic,Christopher Reiser,Giancarlo Biamino +6 more
TLDR
Excimer laser-assisted angioplasty for CLI offers high technical success and limb salvage rates in patients unfit for traditional surgical revascularization, according to a prospective registry at 14 sites in the US and Germany.Abstract:
Purpose:To evaluate the effectiveness of laser-assisted angioplasty for patients with critical limb ischemia (CLI) who were poor candidates for surgical revascularization.Methods:A prospective registry at 14 sites in the US and Germany enrolled 145 patients with 155 critically ischemic limbs; the patients were poor candidates for bypass surgery owing to inadequate target vessel or saphenous vein, prohibitive cardiac disease, or significant comorbidities (ASA class 4). Additional comorbid risk factors included diabetes in 66%, hypertension in 83%, previous stroke in 21%, and myocardial infarction in 23%. Endovascular treatment included guidewire traversal and excimer laser angioplasty followed by balloon angioplasty with optional stenting.Results:Occlusions were present in 92% of limbs. A mean of 2.7±1.4 lesions were treated per limb; the total median treatment length was 11 cm (mean 16.2, range 0.2–123). Stents were implanted in 45% of limbs. Procedural success, defined as <50% residual stenosis in all tr...read more
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Suggested objective performance goals and clinical trial design for evaluating catheter-based treatment of critical limb ischemia
Michael S. Conte,Patrick J. Geraghty,Andrew W. Bradbury,Nathanael D. Hevelone,Stuart R. Lipsitz,Gregory L. Moneta,Mark R. Nehler,Richard J. Powell,Anton N. Sidawy +8 more
TL;DR: For new catheter-based therapies in CLI, OPGs offer a feasible approach for pre-market evaluation using non-randomized trial designs and should incorporate risk stratification in design and reporting as the CLI population is heterogeneous with respect to baseline variables and expected outcomes.
Journal ArticleDOI
Evidence-based protocol for diabetic foot ulcers.
TL;DR: In diabetic foot ulcers, availability of the above modalities, in combination with early recognition and comprehensive treatment, ensures rapid healing, minimizes morbidity and mortality rates, and eliminates toe and limb amputations in the absence of ischemia and osteomyelitis.
Journal ArticleDOI
Classification and Clinical Impact of Restenosis After Femoropopliteal Stenting
Atsushi Tosaka,Yoshimitsu Soga,Osamu Iida,Takayuki Ishihara,Keisuke Hirano,Kenji Suzuki,Hiroyoshi Yokoi,Shinsuke Nanto,Masakiyo Nobuyoshi +8 more
TL;DR: Investigating the relationship between angiographic patterns of in-stent restenosis after femoropopliteal (FP) stenting and the frequency of refractory ISR found them to be important predictors of recurrent ISR and occlusion.
Journal ArticleDOI
An Update on Methods for Revascularization and Expansion of the TASC Lesion Classification to Include Below-the-Knee Arteries: A Supplement to the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II)
Michael R. Jaff,Christopher J. White,William R. Hiatt,Gerry Fowkes,John A. Dormandy,Mahmood K. Razavi,Jim A. Reekers,Lars Norgren +7 more
TL;DR: The intent of this publication is to provide a complete anatomic lower limb TASC lesion classification, including the infrapopliteal segment, and an updated literature review of new endovascular techniques and practice patterns employed by vascular specialists today.
Journal ArticleDOI
An Update on Methods for Revascularization and Expansion of the TASC Lesion Classification to Include Below-the-Knee Arteries: A Supplement to the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II).
Michael R. Jaff,Christopher J. White,William R. Hiatt,Gerry Fowkes,John A. Dormandy,Mahmood K. Razavi,Jim A. Reekers,Lars Norgren +7 more
TL;DR: The intent of this publication is to provide a complete anatomic lower limb TASC lesion classification, including the infrapopliteal segment, and an updated literature review of new endovascular techniques and practice patterns employed by vascular specialists today.
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