BTK arteries angioplasty: Optimal Complex recanalization for BTK arteries

Il semble que vous utilisiez une version obsolète de internet explorer. Internet explorer n'est plus supporté par Microsoft depuis fin 2015. Nous vous invitons à utiliser un navigateur plus récent tel que Firefox, Google Chrome ou Microsoft Edge.

BTK arteries angioplasty: Optimal Complex recanalization for BTK arteries

Case of the month: March 2019

This didactic procedure concerns a 70 years old man, with multiple Cardiovascular risk factors, presenting severe Leftt limb critical ischemia with extensive gangrene in the II-III & IV toes.

He was treated by complete revascularization of both Anterior tibial artery (True to true lumen) & Posterior tibial artery recanalization, Good final angiographic result with acceptable Run off.

WATCH IT NOW

Educational objectives

How to manage patients with Critical Limb ischemia & BTK vessels reocclusion.
Optimal techniques to achieve complete revascularization in Critical Limb ischemia.
How to minimize iodine contrast use during BTK revascularization procedures.
Carboxy-dioxide angiography during BTK revascularization procedures.
Drug Coated Balloon in BTK arteries.

Step-by-Step description

Left CFA antegrade Access with 6F Sheath.
Crossing Anterior tibial artery true lumen with 0.014 guidewire Command ES (Abbott).
Crossing the Plantar Arch through the Dorsalis pedis artery using the Command ES guide wire & Ultraverse Balloon 2.0x40mm (BARD).
Retrograde Crossing of the Posterior tibial artery till the proximal artery.
Predilatation of the Anterior tibial artery & the plantar arch.
Antegrade Crossing of the Posterior tibial artery with a second Command 0.014 guidewire (Abbott).
Multilevel predilatation of the Posterior tivbial artery.
Drug Coated balloon dilatation only for Anterior tibial artery.
Second Balloon diltation of the Posterior tibial artery & the plantar arch.
Final angiographic control with acceptable Run off & good patency of the ATA, PTA & plantar arch.

Biobliography

Peripheral Arterial Diseases (Diagnosis and Treatment of) ESC Clinical Practice Guidelines - Guidelines
Authors:Victor Aboyans Jean-Baptiste Ricco Marie-Louise E L Bartelink
Publication: European Heart Journal (2018) 39, 763–821
Lutonix® 014 DCB global Below the Knee Registry Study: interim 6-month outcomes. - Article
Authors: Thieme M, Lichtenberg M, Brodmann M, Cioppa A, Scheinert D.
Publication:doi: 10.23736/S0021-9509.18.10269-2. Epub 2018 Jan 23.
One Year Primary Patency of Infrapopliteal Angioplasty Using Drug- Eluting Balloons: Single Center Experience at King Hussein Medical Center. - Article
Authors:Haddad SE, Shishani JM, Qtaish I, Rawashdeh MA, Qtaishat BS.
Publication:doi: 10.4103/jcis.JCIS_34_17. eCollection 2017.
Drug-coated balloon angioplasty for the management of recurring infrapopliteal disease in diabetic patients with critical limb ischemia.ink title - Article
Authors:Palena LM, Diaz-Sandoval LJ, Gomez-Jaballera E, Peypoch-Perez O, Sultato E, Brigato C, Brocco E, Manzi M.
Publication: doi: 10.1016/j.carrev.2017.06.006. Epub 2017 Jun 20.
Automated Carbon Dioxide Angiography for the Evaluation and Endovascular Treatment of Diabetic Patients With Critical Limb Ischemia. - Article
Authors:Palena LM, Diaz-Sandoval LJ, Gomez-Jaballera E, Peypoch-Perez O, Sultato E, Brigato C, Brocco E, Manzi M.
Publication:doi: 10.1016/j.carrev.2017.06.006. Epub 2017 Jun 20.

Actus