Impact of transpedal retrograde wire just marker technique on revascularization of below the knee artery occlusions with ambiguous proximal caps in patients with Buerger's disease.

IF 1 4区 医学 Q4 PERIPHERAL VASCULAR DISEASE
Vascular Pub Date : 2024-11-29 DOI:10.1177/17085381241305190
Perihan Varim, Ali Buturak, Ahmet C Çakmak, Ersan Tatli
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引用次数: 0

Abstract

Background: Chronic total occlusions with ambiguous proximal caps present a significant challenge in endovascular interventions of patients with Buerger's disease.

Objective: We aimed to evaluate the effectiveness of transpedal retrograde wire just marker technique in patients with Buerger's disease presenting proximal cap ambiguity and flush occlusions.

Methods: Seventeen patients with the diagnosis of Buerger's disease who had below the knee artery chronic total occlusions with ambiguous proximal caps were enrolled. Procedural success, post-intervention Rutherford stage, wound scores, pedal loop scores, and amputation rates were recorded.

Results: Final study group consisted of 13 patients after exclusion of 4 patients due to pedal loop formation failure and severe vasospasm preventing equipment advancement. Post-intervention angiographic success rate was 100%. The post-intervention Rutherford stage showed excellent improvement (mean preprocedural Rutherford stage = 5 vs mean post-intervention Rutherford stage = 2; p = 0.003). Additionally, the average Saint Elian Wound Score System (SEWSS) decreased significantly (Preprocedural 14.9 ± 4.0 vs Postprocedural 11.3 ± 4.7, p < 0.001) after the interventions. Two patients had a major amputation during the follow-up indicating that higher post-intervention pedal loop scores are associated with higher amputation rates.

Conclusions: Transpedal retrograde wire just marker technique is an effective and practical method for revascularization of below the knee artery occlusions with ambiguous proximal caps. Including pedal loop angioplasty as a routine part of this technique can significantly increase blood supply to the pedal arch., thereby enhancing the likelihood of wound healing.

经趾逆行金属丝标记技术对布氏病患者近端不明确的膝下动脉闭塞血运重建的影响。
背景:近端帽不明确的慢性全闭塞对布氏病患者的血管内干预提出了重大挑战。目的:评价经趾逆行金属丝标记技术对近端帽模糊和冲红闭塞的伯格氏病患者的疗效。方法:选取17例诊断为伯格氏病的膝下动脉慢性全闭塞伴近端动脉帽模糊的患者。记录手术成功率、干预后卢瑟福分期、伤口评分、脚环评分和截肢率。结果:在排除了4例因足袢形成失败和严重血管痉挛阻止器械推进的患者后,最终研究组共13例患者。介入后血管造影成功率为100%。干预后的卢瑟福阶段表现出极好的改善(术前卢瑟福平均阶段= 5 vs干预后卢瑟福平均阶段= 2;P = 0.003)。此外,干预后平均Saint Elian伤口评分系统(SEWSS)显著降低(术前14.9±4.0比术后11.3±4.7,p < 0.001)。随访期间有2例患者发生了大截肢,表明干预后踏板环评分越高,截肢率越高。结论:经足逆行金属丝穿刺技术是治疗近端动脉不明确的膝下动脉闭塞的有效方法。将脚环血管成形术作为这项技术的常规部分可以显著增加足弓的血液供应。,从而提高伤口愈合的可能性。
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
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.
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