Kissing Balloon Technique for Angioplasty of Tibioperoneal Arteries Bifurcation Using Pedal Arterial Retrograde Revascularization.

Case Reports in Vascular Medicine Pub Date : 2018-12-25 eCollection Date: 2018-01-01 DOI:10.1155/2018/9543250
Ahmed Amro, Obadah Aqtash, Adee Elhamdani, Mehiar El-Hamdani
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引用次数: 1

Abstract

Background: Kissing Balloon Technique using retrograde pedal approach together with anterograde common femoral artery (CFA) approach could be the treatment of choice in patients with diseased infrapopliteal artery bifurcation. We report seven cases where the KBT was utilized for the treatment of diseased infrapopliteal artery bifurcation using retrograde pedal access in conjunction with the conventional common femoral artery (CFA) access.

Methods: We reviewed all seven cases that underwent KBT with the combination of pedal and common femoral access in a single-center study from 2014 to 2015 utilizing Rutherford classification severity index; all cases were deemed stage 3 (severe claudication) to stage 6 (severe ischemic ulcers or frank gangrene). With the exception of two cases, contralateral femoral access was obtained, with sheath sizes varying from 4 to 6 French for both CFA and pedal access. Ultrasound was utilized for ipsilateral pedal access in all seven cases.

Results: Arterial revascularization was successfully achieved by the KBT in all patients without any complications. All patients achieved procedural success, which is defined as residual stenosis of less than 30% with no dissection or thrombosis and clinical success that is defined as resolution of symptoms (absence of intermittent claudication and healing of the ulcer) as well as improvement in the arterial brachial index (ABI). During follow-up, out of the seven cases, repeat angiogram was performed for one case, which showed patent arteries with no residual lesions.

Conclusions: In patients with popliteal and tibioperoneal trunk bifurcation lesions, Kissing Balloon Technique using retrograde pedal access in conjunction with the conventional anterograde access appeared to be successful, safe, and effective technique with lower access site complications and shorter procedure time.

接吻球囊技术应用足动脉逆行血运重建术治疗胫腓动脉分叉。
背景:接吻球囊技术采用逆行踏板入路联合顺行股总动脉(CFA)入路可作为治疗患病的股下动脉分叉患者的首选方法。我们报告了七个病例,其中KBT被用于治疗病变的髌下动脉分叉,使用逆行踏板通道与传统的股总动脉(CFA)通道相结合。方法:采用卢瑟福分级严重程度指数对2014 - 2015年单中心研究中7例合并足部和股总通路的KBT患者进行回顾性分析;所有病例均为3期(严重跛行)至6期(严重缺血性溃疡或坦白性坏疽)。除2例外,均采用对侧股骨入路,CFA和足部入路的鞘径从4到6 French不等。7例患者均采用超声检查同侧足部通路。结果:所有患者均成功完成动脉血运重建,无并发症发生。所有患者均获得手术成功,其定义为残余狭窄小于30%,无夹层或血栓形成;临床成功定义为症状缓解(无间歇性跛行和溃疡愈合)以及动脉肱指数(ABI)改善。随访中,7例患者中有1例复查血管造影,显示动脉未闭,无残留病变。结论:在腘窝和胫腓主干分叉病变患者中,采用逆行足部入路结合传统顺行入路的接吻球囊技术是一种成功、安全、有效的技术,其入路并发症少,手术时间短。
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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