critical ischemia

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Drug-Coated Balloons in Critical Ischemia: The Paradigm of Randomized Evidence vs. Logbooks

This research, which included thousands of patients treated for chronic inferior limb ischemia with drug-coated balloons, did not show an association between said devices and the increased mortality observed in some randomized trials.  The long-term evidence from plenty of real-world patients contradicts what has been shown in randomized trials, leaving an information gap. Endovascular revascularization...

Nuevas estrategias en el territorio femoropoplíteo

Common Femoral Artery Endarterectomy Plus Angioplasty in Critical Ischemia

This prospective study analyzed patients with critical lower limb ischemia (due to complex, multiple lesions in several places) who were treated uniformly with common femoral artery endarterectomy combined with angioplasty to improve inflow and/or outflow. This hybrid treatment, which must be carried out by a team, can be greatly beneficial for this high-risk patient group...

¿Es durable el TAVI a más de 5 años?

Surprises in the Physiopathology of Critical Ischemia

Luminal thrombotic occlusions associated with non-significant atherosclerosis are commonly observed in patients with critical lower limb ischemia, which suggests the possibility of thromboembolic disease as a great contributor to ischemia. This was particularly verifiable in infrapopliteal vessels, thus showing a possible mechanism of progression from peripheral vascular disease to critical ischemia, as well as a...

Apuntar a la lesión parece el secreto de la isquemia crítica

Lesion Targeting Seems to Be the Secret in Critical Ischemia

Ulcers that do not heal, thus threatening the integrity of a lower limb in patients with critical ischemia, is a main concern. Sometimes, despite successful revascularization, major amputation cannot be prevented. The anatomical description of angiosomes started in the 70s as a way of optimizing tissue grafts. Angiosomes are basically blocks of tissue that include...

Angioplastia vs cirugía en isquemia crítica a largo plazo

Angioplasty vs. Surgery in Long-Term Critical Ischemia

Critical ischemia is the most advanced form of peripheral arterial disease, and it is characterized by ischemic rest pain and ulcers or gangrene. Revascularization is obviously positioned as the first-line treatment, and guidelines recommend both possible strategies (surgery or angioplasty) largely based on the findings of the BASIL trial (British Angioplasty versus Surgery in Ischemic...

DES in critical ischemia caused by infrapopliteal lesions

Original Title: Percutaneous Transluminal Angioplasty and Drug-Eluting Stents for Infrapopliteal Lesions in Critical Limb Ischemia (PADI) Trial. Reference: Marlon I. Spreen et al. Circ Cardiovasc Interv. 2016 Feb;9(2):e002376.   The treatment of infrapopliteal lesions in patients with critical limb ischemia is limited by the high rates of restenosis. The most frequent course of treatment is...

Infrapatellar balloon angioplasty, the easiest option and with better results in critical ischemia with tissue loss

Original title: Longitudinal outcomes After Tibioperoneal Angioplasty Alone Compared to Tibial Stenting and Atherectomy for Critical Limb ischemia. Reference: Shaun Reynolds et al. Vascular and and Endovascular Surgery 2013 47(7):507-512 The Infrapatellar peripheral vascular disease has increased in recent years, relating to tissue loss and amputation. The therapeutic strategy is not clear, let alone the use of stents...

ATC guiada por iFR ¿es igual en la DA que en el resto de los vasos?

LIFE-BTK | Critical Limb Ischemia: Use of Bioresorbable Scaffold in Infrapatellar Lesions (LIFE-BTK)

Advanced stages of peripheral artery disease cause significant limitations in patients, such as critical limb ischemia (CLI), which manifests with resting pain and gangrene or ulcers of difficult resolution. Uncontrolled progression of this pathology might lead to major amputation, reduced life expectancy and increased healthcare costs.  Prior research on infrapopliteal territory have shown contradicting results....

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