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Endovascular Technologies for Chronic Critical Limb Ischemia

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Critical Limb Ischemia

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Abstract

Endovascular interventions for symptomatic peripheral artery disease (PAD) have undergone significant progress in recent years. Trials, however, remain limited for evaluating the efficacy and safety of these technologies in critical limb ischemia (CLI). This chapter attempts to review the mechanism of restenosis which has provided the impetus for the development of multiple endovascular options for PAD interventions. Following it is a review of available evidence for the use of percutaneous transluminal angioplasty (PTA), stent technologies including bare-metal (BMS), bare-nitinol, and drug-eluting stents (DES); cryoplasty; cutting and scoring balloons; and drug-eluting balloon (DEB) technologies. Finally, adjunctive technologies designed for intervention in special circumstances are reviewed including atherectomy technologies, technologies for intervening on chronic total occlusions (CTOs), and embolic protection devices.

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Authors and Affiliations

  1. Cardiology, University of Wisconsin, Madison, WI, USA

    Ambrose F. Panico DO & Asif Jafferani MBBS

  2. Loyola University Chicago, Stritch School of Medicine, Loyola University, Maywood, IL, USA

    Paul A. Johnson BS

  3. Medicine, Cardiology, Loyola University Medical Center, Maywood, IL, USA

    John J. Lopez MD

  4. Internal Medicine, Cardiovascular Medicine UC Davis Vascular Center, Sacramento, CA, USA

    John R. Laird MD

  5. Medicine, Cardiology, Vascular and Endovascular Medicine, Loyola University Medical Center, Maywood, IL, USA

    Robert S. Dieter MD, RVT

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  1. Loyola University Medical Center, Maywood, Illinois, USA

    Robert S. Dieter

  2. Northwestern Medicine Central DuPage Hospital, Glen Ellyn, Illinois, USA

    Raymond A. Dieter, Jr

  3. The University of Tennessee Medical Center, Knoxville, Tennessee, USA

    Raymond A. Dieter, III

  4. West Virginia University, Charleston, West Virginia, USA

    Aravinda Nanjundappa

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Panico, A.F., Jafferani, A., Johnson, P.A., Lopez, J.J., Laird, J.R., Dieter, R.S. (2017). Endovascular Technologies for Chronic Critical Limb Ischemia. In: Dieter, R., Dieter, Jr, R., Dieter, III, R., Nanjundappa, A. (eds) Critical Limb Ischemia. Springer, Cham. https://doi.org/10.1007/978-3-319-31991-9_35

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