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

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  • Additional Information
    • Source:
      Publisher: Sage Country of Publication: England NLM ID: 101196722 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1708-539X (Electronic) Linking ISSN: 17085381 NLM ISO Abbreviation: Vascular Subsets: MEDLINE
    • Publication Information:
      Publication: Dec. 2012- : London : Sage
      Original Publication: Hamilton, Ont., Canada : BC Decker, [2004]-
    • Subject Terms:
      Tibial Arteries*/diagnostic imaging ; Tibial Arteries*/physiopathology ; Tibial Arteries*/surgery ; Peripheral Arterial Disease*/diagnostic imaging ; Peripheral Arterial Disease*/physiopathology ; Peripheral Arterial Disease*/therapy ; Peripheral Arterial Disease*/surgery ; Amputation, Surgical* ; Limb Salvage* ; Vascular Patency* ; Chronic Limb-Threatening Ischemia*/surgery; Humans ; Male ; Aged ; Retrospective Studies ; Female ; Middle Aged ; Aged, 80 and over ; Time Factors ; Treatment Outcome ; Risk Factors ; Endovascular Procedures/adverse effects ; Chronic Disease ; Ischemia/physiopathology ; Ischemia/diagnostic imaging ; Ischemia/surgery ; Ischemia/therapy
    • 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.
      Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
    • Contributed Indexing:
      Keywords: Peripheral artery; chronic limb-threatening ischemia; chronic total occlusion; endovascular therapy; single access; tibial anterior artery
    • Publication Date:
      Date Created: 20230809 Date Completed: 20241123 Latest Revision: 20241123
    • Publication Date:
      20241123
    • Accession Number:
      10.1177/17085381231192691
    • Accession Number:
      37553759