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

IF 1 4区医学 Q4 PERIPHERAL VASCULAR DISEASE

Vascular Pub Date : 2024-12-01 Epub Date: 2023-08-08 DOI:10.1177/17085381231192691

Daniel Raskin, Yiftach Barash, Daniel Silverberg, Moshe Halak, Hatem Hater, Boris Khaitovich

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引用次数: 0

Abstract

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.

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逆行胫骨入路为慢性肢体缺血患者进行慢性全闭塞血管再通。

目的：评估胫骨单侧入路治疗同侧慢性肢体缺血（CLTI）患者慢性全闭塞（CTO）的效果：在这项回顾性研究中，收集了 2017 年 3 月至 2021 年 3 月期间通过胫骨动脉入路治疗同侧 CTO 患者的数据。57名患者（42名男性，平均年龄73岁；年龄范围47-96岁）的59条肢体接受了治疗。患者的症状根据卢瑟福分类进行分类。随访一年的终点是无重大截肢和是否需要再次干预：在接受治疗的59条肢体中，有57条（97%）获得了技术成功。接受治疗的多级肢体包括5条髂总动脉和12条髂外动脉、23条股总动脉和37条股浅动脉、23条股骨腘动脉、14条腘动脉和4条旁路。闭塞的平均长度为 186 毫米（7-670 毫米不等）。45名患者的治疗肢体的卢瑟福分级为5级和6级，14名患者为4级。有三例手术并发症发生，并在同一手术中得到成功治疗。术后未立即出现并发症。中位随访时间为 13 个月（1-45.3 个月）。9条肢体在平均6个月后需要再次手术。一年内无截肢率为91.2%：结论：经同侧胫骨动脉单次入路治疗CLTI患者的CTO是一种有用、有效且安全的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vascular 医学-外周血管病

CiteScore

2.30

自引率

9.10%

发文量

196

审稿时长

6-12 weeks

期刊介绍： Vascular provides readers with new and unusual up-to-date articles and case reports focusing on vascular and endovascular topics. It is a highly international forum for the discussion and debate of all aspects of this distinct surgical specialty. It also features opinion pieces, literature reviews and controversial issues presented from various points of view.