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Iezzi R, Posa A, Santoro M, Nestola M, Contegiacomo A, Tinelli G, Paolini A, Flex A, Pitocco D, Snider F, Bonomo L. Cutting Balloon Angioplasty in the Treatment of Short Infrapopliteal Bifurcation Disease. J Endovasc Ther 2015; 22:485-92. [PMID: 26187973 DOI: 10.1177/1526602815594250] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate the safety, feasibility, and effectiveness of cutting balloon angioplasty in the management of infrapopliteal bifurcation disease. METHODS Between November 2010 and March 2013, 23 patients (mean age 69.6±9.01 years, range 56-89; 16 men) suffering from critical limb ischemia were treated using cutting balloon angioplasty (single cutting balloon, T-shaped double cutting balloon, or double kissing cutting balloon technique) for 47 infrapopliteal artery bifurcation lesions (16 popliteal bifurcation and 9 tibioperoneal bifurcation) in 25 limbs. Follow-up consisted of clinical examination and duplex ultrasonography at 1 month and every 3 months thereafter. RESULTS All treatments were technically successful. No 30-day death or adverse events needing treatment were registered. No flow-limiting dissection was observed, so no stent implantation was necessary. The mean postprocedure minimum lumen diameter and acute gain were 0.28±0.04 and 0.20±0.06 cm, respectively, with a residual stenosis of 0.04±0.02 cm. Primary and secondary patency rates were estimated as 89.3% and 93.5% at 6 months and 77.7% and 88.8% at 12 months, respectively; 1-year primary and secondary patency rates of the treated bifurcation were 74.2% and 87.0%, respectively. The survival rate estimated by Kaplan-Meier analysis was 82.5% at 1 year. CONCLUSION Cutting balloon angioplasty seems to be a safe and effective tool in the routine treatment of short/ostial infrapopliteal bifurcation lesions, avoiding procedure-related complications, overcoming the limitations of conventional angioplasty, and improving the outcome of catheter-based therapy.
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Affiliation(s)
- Roberto Iezzi
- Department of Radiological Sciences, Institute of Radiology, "A. Gemelli" Hospital, Catholic University, Rome, Italy
| | - Alessandro Posa
- Department of Radiological Sciences, Institute of Radiology, "A. Gemelli" Hospital, Catholic University, Rome, Italy
| | - Marco Santoro
- Department of Radiological Sciences, Institute of Radiology, "A. Gemelli" Hospital, Catholic University, Rome, Italy
| | - Massimiliano Nestola
- Department of Radiological Sciences, Institute of Radiology, "A. Gemelli" Hospital, Catholic University, Rome, Italy
| | - Andrea Contegiacomo
- Department of Radiological Sciences, Institute of Radiology, "A. Gemelli" Hospital, Catholic University, Rome, Italy
| | - Giovanni Tinelli
- Institute of Vascular Surgery, "A. Gemelli" Hospital, Catholic University, Rome, Italy
| | - Alessandra Paolini
- Department of Radiological Sciences, Institute of Radiology, "A. Gemelli" Hospital, Catholic University, Rome, Italy
| | - Andrea Flex
- Department of Medicine, "A. Gemelli" Hospital, Catholic University, Rome, Italy
| | - Dario Pitocco
- Department of Medicine, "A. Gemelli" Hospital, Catholic University, Rome, Italy
| | - Francesco Snider
- Institute of Vascular Surgery, "A. Gemelli" Hospital, Catholic University, Rome, Italy
| | - Lorenzo Bonomo
- Department of Radiological Sciences, Institute of Radiology, "A. Gemelli" Hospital, Catholic University, Rome, Italy
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