ABSTRACT
PURPOSE OF REVIEW: This review intends to discuss the latest endovascular and surgical advancement in the treatment of critical limb-threatening ischemia (CLTI). RECENT FINDINGS: We discuss novel endovascular technological advancements such as intravascular lithotripsy, the Tack endovascular stent, the PQ Bypass DETOUR system, and the LimFlow System for deep venous arterialization (DVA) in the very high risk "no-option" CLTI population. We also discuss the increasing adoption of radial and pedal approaches for endovascular revascularization and the tibiopedal arterial minimally invasive (TAMI) technique. On the surgical front, we discuss the distal vein patch technique and surgical and hybrid DVA. Recent advancements in the treatment options of CLTI will likely lead to reducing the rate of major amputations if they are adopted in a collaborative environment in order to apply the most appropriate treatment option to each individual patient based on the anatomy, comorbidities, functional status, and local expertise.
Subject(s)
Endovascular Procedures , Peripheral Arterial Disease , Amputation, Surgical , Chronic Disease , Chronic Limb-Threatening Ischemia , Endovascular Procedures/methods , Humans , Ischemia/surgery , Limb Salvage , Peripheral Arterial Disease/surgery , Risk Factors , Time Factors , Treatment OutcomeABSTRACT
Open repair of abdominal aortic aneurysm is still considered the gold standard against which endovascular repair is measured. We describe two cases of open repair complicated by bleeding where endovascular treatment proved to be life-saving.
Subject(s)
Aneurysm, False/surgery , Aneurysm, Ruptured/surgery , Aortic Aneurysm, Abdominal/surgery , Blood Vessel Prosthesis Implantation , Postoperative Hemorrhage/surgery , Vascular Surgical Procedures/adverse effects , Aged, 80 and over , Aneurysm, False/diagnostic imaging , Aneurysm, False/etiology , Aneurysm, Ruptured/diagnostic imaging , Aneurysm, Ruptured/etiology , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortography/methods , Humans , Male , Postoperative Hemorrhage/diagnostic imaging , Reoperation , Tomography, X-Ray Computed , Treatment Outcome , Ultrasonography, Doppler, ColorABSTRACT
Lower extremity revascularization is routinely performed for limb salvage purposes when critical limb ischemia has developed in a patient. Traditional reconstructions have been well described in the literature. We present a case of internal iliac artery endarterectomy with aortointernal iliac bypass for the treatment of limb ischemia.
