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Catheter Cardiovasc Interv. 2008 Jul 1;72(1):112-5. doi: 10.1002/ccd.21557.

Drug eluting stents for below the knee lesions in patients with critical limb ischemia : long-term follow-up.

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  • 1Heart and Vascular Institute, Memorial Hermann Hospital, Texas Medical Center, Houston, Texas, USA. orosales@mcheart.net

Abstract

OBJECTIVES:

The purpose of this study was to assess the long-term limb preservation and/or healing of ulcers in patients with critical limb ischemia (CLI) and severe infrapopliteal atherosclerotic disease treated with drug eluting stents (DES).

BACKGROUND:

Percutaneous revascularization has become an effective treatment for CLI in patients with infrapopliteal atherosclerotic disease. Recent reports using DES in patients with CLI have documented excellent short-term infrapopliteal vessel patency. Higher primary patency rates in infrapopliteal vessels treated with DES could translate into better long-term clinical outcomes and improved limb salvage rates.

METHODS:

Twenty-four consecutive patients with CLI (defined as rest pain, nonhealing ulcers, or gangrene) because of severe infrapopliteal disease were treated with DES from August 2004 to June 2006.

RESULTS:

Procedural success was achieved in 96% (27/28) of targeted lesions. There were no procedure-related deaths, acute vessel thrombosis events, or need for urgent surgical intervention. There was one case of distal embolization. Clinical follow up, ranging 8-34 months, is available for 100% of patients of which 83% (20/24) achieved limb preservation and healing. Angiographic and/or sonographic follow up, ranging 6-34 months, is available in 79% (19/24) of patients of which 95% (18/19) had patent target vessels.

CONCLUSIONS:

DES is a safe and effective long-term option for CLI due to severe infrapopliteal arterial disease. Long-term vascular patency led to a high rate of limb preservation and low amputation rate. A multicenter trial should further elucidate the role of DES in the treatment of CLI.

(c) 2008 Wiley-Liss, Inc.

PMID:
18412272
[PubMed - indexed for MEDLINE]
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