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Superficial Femoral Artery Endovascular Therapy with Atherectomy

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Endovascular Interventions

Abstract

Peripheral vascular disease is better recognized as an epidemic that’s impacting millions of patients and their families. Health-care providers currently consider PVD as a significant comorbidity and have been actively screening, treating, and spreading public awareness. In addition to medical therapy, surgery has been considered the mainstay of therapy for years. The recent advancement in endovascular technology and the increasing level of expertise by endovascular specialist allow revascularization in patients deemed inoperable in the past. This chapter highlights through our case presentation the current evidence behind endovascular therapy in patients with superficial femoral artery disease. We also discuss some of the current devices available and used by endovascular operators.

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References

  1. Bates MC, Aburahma AF. An update on endovascular therapy of the lower extremities. J Endovasc Ther. 2004;11 Suppl 2:II107–27.

    PubMed  Google Scholar 

  2. Shammas NW. Epidemiology, classification, and modifiable risk factors of peripheral arterial disease. Vasc Health Risk Manag. 2007;3(2):229–34.

    Article  PubMed  Google Scholar 

  3. McDermott MM. The magnitude of the problem of peripheral arterial disease: epidemiology and clinical significance. Cleve Clin J Med. 2006;73 Suppl 4:S2–7.

    Article  PubMed  Google Scholar 

  4. Cheng SW, Ting AC, Ho P. Angioplasty and primary stenting of high-grade, long-segment superficial femoral artery disease: is it worthwhile? Ann Vasc Surg. 2003;17(4):430–7.

    Article  PubMed  Google Scholar 

  5. Forbes JF, Adam DJ, Bell J, Fowkes FG, Gillespie I, Raab GM, et al. Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial: health-related quality of life outcomes, resource utilization, and cost-effectiveness analysis. J Vasc Surg. 2010;51(5 Suppl):43S–5151.

    Article  PubMed  Google Scholar 

  6. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG, et al. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007;45(Suppl S):S5–67.

    Article  PubMed  Google Scholar 

  7. Rutherford RB, Baker JD, Ernst C, Johnston KW, Porter JM, Ahn S, et al. Recommended standards for reports dealing with lower extremity ischemia: revised version. J Vasc Surg. 1997;26(3):517–38.

    Article  PubMed  CAS  Google Scholar 

  8. Krankenberg H, Schluter M, Steinkamp HJ, Burgelin K, Scheinert D, Schulte KL, et al. Nitinol stent implantation versus percutaneous transluminal angioplasty in superficial femoral artery lesions up to 10 cm in length: the femoral artery stenting trial (FAST). Circulation. 2007;116(3):285–92.

    Article  PubMed  CAS  Google Scholar 

  9. Laird JR, Katzen BT, Scheinert D, Lammer J, Carpenter J, Buchbinder M, et al. Nitinol stent implantation versus balloon angioplasty for lesions in the superficial femoral artery and proximal popliteal artery: twelve-month results from the RESILIENT randomized trial. Circ Cardiovasc Interv. 2010;3(3):267–76.

    Article  PubMed  Google Scholar 

  10. Schillinger M, Sabeti S, Dick P, Amighi J, Mlekusch W, Schlager O, et al. Sustained benefit at 2 years of primary femoropopliteal stenting compared with balloon angioplasty with optional stenting. Circulation. 2007;115(21):2745–9.

    Article  PubMed  Google Scholar 

  11. Schillinger M, Sabeti S, Loewe C, Dick P, Amighi J, Mlekusch W, et al. Balloon angioplasty versus implantation of nitinol stents in the superficial femoral artery. N Engl J Med. 2006;354(18):1879–88.

    Article  PubMed  CAS  Google Scholar 

  12. Nguyen BN, Conrad MF, Guest JM, Hackney L, Patel VI, Kwolek CJ, et al. Late outcomes of balloon angioplasty and angioplasty with selective stenting for superficial femoral-popliteal disease are equivalent. J Vasc Surg. 2011;54(4):1051–7.e1.

    Article  PubMed  Google Scholar 

  13. Faries PL, Logerfo FW, Arora S, Hook S, Pulling MC, Akbari CM, et al. A comparative study of alternative conduits for lower extremity revascularization: all-autogenous conduit versus prosthetic grafts. J Vasc Surg. 2000;32(6):1080–90.

    Article  PubMed  CAS  Google Scholar 

  14. Nasr MK, McCarthy RJ, Budd JS, Horrocks M. Infrainguinal bypass graft patency and limb salvage rates in critical limb ­ischemia: influence of the mode of presentation. Ann Vasc Surg. 2003;17(2):192–7.

    Article  PubMed  CAS  Google Scholar 

  15. Desgranges P, Boufi M, Lapeyre M, Tarquini G, van Laere O, Losy F, et al. Subintimal angioplasty: feasible and durable. Eur J Vasc Endovasc Surg. 2004;28(2):138–41.

    PubMed  CAS  Google Scholar 

  16. Laxdal E, Jenssen GL, Pedersen G, Aune S. Subintimal angioplasty as a treatment of femoropopliteal artery occlusions. Eur J Vasc Endovasc Surg. 2003;25(6):578–82.

    Article  PubMed  CAS  Google Scholar 

  17. Markose G, Miller FN, Bolia A. Subintimal angioplasty for femoro-popliteal occlusive disease. J Vasc Surg. 2010;52(5):1410–6.

    Article  PubMed  Google Scholar 

  18. Nydahl S, Hartshorne T, Bell PR, Bolia A, London NJ. Subintimal angioplasty of infrapopliteal occlusions in critically ischaemic limbs. Eur J Vasc Endovasc Surg. 1997;14(3):212–6.

    Article  PubMed  CAS  Google Scholar 

  19. Vraux H, Hammer F, Verhelst R, Goffette P, Vandeleene B. Subintimal angioplasty of tibial vessel occlusions in the treatment of critical limb ischaemia: mid-term results. Eur J Vasc Endovasc Surg. 2000;20(5):441–6.

    Article  PubMed  CAS  Google Scholar 

  20. Bosiers M, Deloose K, Callaert J, Moreels N, Keirse K, Verbist J, et al. Results of the Protege EverFlex 200-mm-long nitinol stent (ev3) in TASC C and D femoropopliteal lesions. J Vasc Surg. 2011;54(4):1042–50.

    Article  PubMed  Google Scholar 

  21. Zeller T, Frank U, Burgelin K, Schwarzwalder U, Flugel PC, Neumann FJ. Initial clinical experience with percutaneous atherectomy in the infragenicular arteries. J Endovasc Ther. 2003;10(5):987–93.

    Article  PubMed  Google Scholar 

  22. Zeller T, Rastan A, Schwarzwalder U, Frank U, Burgelin K, Amantea P, et al. Percutaneous peripheral atherectomy of femoropopliteal stenoses using a new-generation device: six-month results from a single-center experience. J Endovasc Ther. 2004;11(6):676–85.

    Article  PubMed  Google Scholar 

  23. Zeller T, Rastan A, Schwarzwalder U, Frank U, Burgelin K, Amantea P, et al. Midterm results after atherectomy-assisted angioplasty of below-knee arteries with use of the Silverhawk device. J Vasc Interv Radiol. 2004;15(12):1391–7.

    Article  PubMed  Google Scholar 

  24. Zeller T, Rastan A, Sixt S, Schwarzwalder U, Schwarz T, Frank U, et al. Long-term results after directional atherectomy of femoro-popliteal lesions. J Am Coll Cardiol. 2006;48(8):1573–8.

    Article  PubMed  Google Scholar 

  25. Zeller T, Sixt S, Schwarzwalder U, Schwarz T, Frank U, Burgelin K, et al. Two-year results after directional atherectomy of ­infrapopliteal arteries with the SilverHawk device. J Endovasc Ther. 2007;14(2):232–40.

    Article  PubMed  Google Scholar 

  26. Ramaiah V, Gammon R, Kiesz S, Cardenas J, Runyon JP, Fail P, et al. Midterm outcomes from the TALON Registry: treating peripherals with SilverHawk: outcomes collection. J Endovasc Ther. 2006;13(5):592–602.

    Article  PubMed  Google Scholar 

  27. Heuser RR. Treatment of lower extremity vascular disease: the Diamondback 360 degrees Orbital Atherectomy System. Expert Rev Med Devices. 2008;5(3):279–86.

    Article  PubMed  Google Scholar 

  28. Safian RD, Niazi K, Runyon JP, Dulas D, Weinstock B, Ramaiah V, et al. Orbital atherectomy for infrapopliteal disease: device concept and outcome data for the OASIS trial. Catheter Cardiovasc Interv. 2009;73(3):406–12.

    PubMed  Google Scholar 

  29. Laird JR, Zeller T, Gray BH, Scheinert D, Vranic M, Reiser C, et al. Limb salvage following laser-assisted angioplasty for critical limb ischemia: results of the LACI multicenter trial. J Endovasc Ther. 2006;13(1):1–11.

    Article  PubMed  Google Scholar 

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Mustapha, J.A., Das, T., Saab, F.A. (2014). Superficial Femoral Artery Endovascular Therapy with Atherectomy. In: Dieter, R., Dieter, Jr., R., Dieter, III, R. (eds) Endovascular Interventions. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7312-1_52

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  • DOI: https://doi.org/10.1007/978-1-4614-7312-1_52

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7311-4

  • Online ISBN: 978-1-4614-7312-1

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