Review of the Latest Percutaneous Devices in Critical Limb Ischemia

Overview

Journal J Clin Med

Specialty General Medicine

Date 2018 Apr 18

PMID 29661987

Citations 4

Authors

Leila Haghighat

Sophia Elissa Altin

Robert R Attaran

Carlos Mena-Hurtado

Christopher J Regan

Affiliations

Soon will be listed here.

Abstract

Critical limb ischemia (CLI) is a terminal stage of peripheral arterial disease that, in the absence of intervention, may lead to lower extremity amputation or death. Endovascular interventions have become a first-line approach to the management of CLI and have advanced considerably within the past decade. This review summarizes the types of percutaneous devices and the techniques that are available for the management of CLI and the data supporting their use. These include devices that establish and maintain vessel patency, including percutaneous transluminal angioplasty, drug-coated balloons, bare metal stents, drug-eluting stents, bioresorbable vascular scaffolds, and atherectomy; devices that provide protection from embolization; and, cell-based therapies. Additionally, ongoing trials with important implications for the field are discussed.

Citing Articles

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Comparative analysis of mouse bone marrow and adipose tissue mesenchymal stem cells for critical limb ischemia cell therapy.

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References

Sixt S, Scheinert D, Rastan A, Krankenberg H, Steinkamp H, Schmidt A . One-year outcome after percutaneous rotational and aspiration atherectomy in infrainguinal arteries in patient with and without type 2 diabetes mellitus. Ann Vasc Surg. 2011; 25(4):520-9. DOI: 10.1016/j.avsg.2010.10.007. View

Zeller T, Baumgartner I, Scheinert D, Brodmann M, Bosiers M, Micari A . Drug-eluting balloon versus standard balloon angioplasty for infrapopliteal arterial revascularization in critical limb ischemia: 12-month results from the IN.PACT DEEP randomized trial. J Am Coll Cardiol. 2014; 64(15):1568-76. DOI: 10.1016/j.jacc.2014.06.1198. View

Tepe G, Laird J, Schneider P, Brodmann M, Krishnan P, Micari A . Drug-coated balloon versus standard percutaneous transluminal angioplasty for the treatment of superficial femoral and popliteal peripheral artery disease: 12-month results from the IN.PACT SFA randomized trial. Circulation. 2014; 131(5):495-502. PMC: 4323569. DOI: 10.1161/CIRCULATIONAHA.114.011004. View

Ko S, Bandyk D . Therapeutic angiogenesis for critical limb ischemia. Semin Vasc Surg. 2015; 27(1):23-31. DOI: 10.1053/j.semvascsurg.2014.10.001. View

Agarwal S, Sud K, Shishehbor M . Nationwide Trends of Hospital Admission and Outcomes Among Critical Limb Ischemia Patients: From 2003-2011. J Am Coll Cardiol. 2016; 67(16):1901-13. DOI: 10.1016/j.jacc.2016.02.040. View

Schanzer A, Mega J, Meadows J, Samson R, Bandyk D, Conte M . Risk stratification in critical limb ischemia: derivation and validation of a model to predict amputation-free survival using multicenter surgical outcomes data. J Vasc Surg. 2009; 48(6):1464-71. PMC: 2765219. DOI: 10.1016/j.jvs.2008.07.062. View

Feiring A, Krahn M, Nelson L, Wesolowski A, Eastwood D, Szabo A . Preventing leg amputations in critical limb ischemia with below-the-knee drug-eluting stents: the PaRADISE (PReventing Amputations using Drug eluting StEnts) trial. J Am Coll Cardiol. 2010; 55(15):1580-9. DOI: 10.1016/j.jacc.2009.11.072. View

Soga Y, Iida O, Takahara M, Takahaera M, Hirano K, Suzuki K . Two-year life expectancy in patients with critical limb ischemia. JACC Cardiovasc Interv. 2014; 7(12):1444-9. DOI: 10.1016/j.jcin.2014.06.018. View

Zeller T, Langhoff R, Rocha-Singh K, Jaff M, Blessing E, Amann-Vesti B . Directional Atherectomy Followed by a Paclitaxel-Coated Balloon to Inhibit Restenosis and Maintain Vessel Patency: Twelve-Month Results of the DEFINITIVE AR Study. Circ Cardiovasc Interv. 2017; 10(9). PMC: 5610565. DOI: 10.1161/CIRCINTERVENTIONS.116.004848. View

10.

Karnabatidis D, Katsanos K, Kagadis G, Ravazoula P, Diamantopoulos A, Nikiforidis G . Distal embolism during percutaneous revascularization of infra-aortic arterial occlusive disease: an underestimated phenomenon. J Endovasc Ther. 2006; 13(3):269-80. DOI: 10.1583/05-1771.1. View

11.

Rocha-Singh K, Jaff M, Joye J, Laird J, Ansel G, Schneider P . Major adverse limb events and wound healing following infrapopliteal artery stent implantation in patients with critical limb ischemia: the XCELL trial. Catheter Cardiovasc Interv. 2012; 80(6):1042-51. DOI: 10.1002/ccd.24485. View

12.

Palena L, Diaz-Sandoval L, Sultato E, Brigato C, Candeo A, Brocco E . Feasibility and 1-Year outcomes of subintimal revascularization with supera stenting of long femoropopliteal occlusions in critical limb ischemia: The "Supersub" Study. Catheter Cardiovasc Interv. 2016; 89(5):910-920. DOI: 10.1002/ccd.26863. View

13.

Teraa M, Sprengers R, van der Graaf Y, Peters C, Moll F, Verhaar M . Autologous bone marrow-derived cell therapy in patients with critical limb ischemia: a meta-analysis of randomized controlled clinical trials. Ann Surg. 2013; 258(6):922-9. DOI: 10.1097/SLA.0b013e3182854cf1. View

14.

Das T, McNamara T, Gray B, Sedillo G, Turley B, Kollmeyer K . Primary cryoplasty therapy provides durable support for limb salvage in critical limb ischemia patients with infrapopliteal lesions: 12-month follow-up results from the BTK Chill Trial. J Endovasc Ther. 2009; 16(2 Suppl 2):II19-30. DOI: 10.1583/08-2652.1. View

15.

Banerjee A, Sarode K, Mohammad A, Brilakis E, Banerjee S, Shammas G . Safety and Effectiveness of the Nav-6 Filter in Preventing Distal Embolization During Jetstream Atherectomy of Infrainguinal Peripheral Artery Lesions. J Invasive Cardiol. 2016; 28(8):330-3. View

16.

Teraa M, Sprengers R, Schutgens R, Slaper-Cortenbach I, van der Graaf Y, Algra A . Effect of repetitive intra-arterial infusion of bone marrow mononuclear cells in patients with no-option limb ischemia: the randomized, double-blind, placebo-controlled Rejuvenating Endothelial Progenitor Cells via Transcutaneous Intra-arterial.... Circulation. 2015; 131(10):851-60. DOI: 10.1161/CIRCULATIONAHA.114.012913. View

17.

McKinsey J, Zeller T, Rocha-Singh K, Jaff M, Garcia L . Lower extremity revascularization using directional atherectomy: 12-month prospective results of the DEFINITIVE LE study. JACC Cardiovasc Interv. 2014; 7(8):923-33. DOI: 10.1016/j.jcin.2014.05.006. View

18.

Laird J, Zeller T, Gray B, Scheinert D, Vranic M, Reiser C . Limb salvage following laser-assisted angioplasty for critical limb ischemia: results of the LACI multicenter trial. J Endovasc Ther. 2006; 13(1):1-11. DOI: 10.1583/05-1674.1. View

19.

Varcoe R, Schouten O, Thomas S, Lennox A . Experience With the Absorb Everolimus-Eluting Bioresorbable Vascular Scaffold in Arteries Below the Knee: 12-Month Clinical and Imaging Outcomes. JACC Cardiovasc Interv. 2016; 9(16):1721-8. DOI: 10.1016/j.jcin.2016.06.005. View

20.

Scheinert D, Katsanos K, Zeller T, Koppensteiner R, Commeau P, Bosiers M . A prospective randomized multicenter comparison of balloon angioplasty and infrapopliteal stenting with the sirolimus-eluting stent in patients with ischemic peripheral arterial disease: 1-year results from the ACHILLES trial. J Am Coll Cardiol. 2012; 60(22):2290-5. DOI: 10.1016/j.jacc.2012.08.989. View