Library

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Review of the literature

Treatment of CLTI in patients with chronic kidney disease

Dr. Reimers and Dr. Ferraresi (Interventional Cardiologists, Milan, Italy) present an overview of the challenges and treatment options in patients with critical limb-threatening ischemia and chronic kidney disease (CKD). They explain the BAD and SAD classification and its impact on the final outcome. Finally, a comprehensive review of the literature regarding different treatment options in CKD and hemodialysis patients with CLI is provided.

October 22, 2018 No Comments
Poll 01/10/2018 – 31/10/2018

Critical limb-threatening ischemia – CLI Global Society

Patient’s characteristics

 

Gender: Male

Age: 79 years old

Comorbidity: Arterial hypertension, hypercholesterinemia, chronic kidney disease (GFR: 53 ml/min/1,73m²), NYHA II, Coronary artery disease, previous CABG

Symptoms:  Toe ulceration of the left limb

Previous operations: None

ABI: incompressible, Toe pressure: 32 mmHg

Vascular Imaging – Duplex ultrasound: Isolated tibial vessel disease

Recorded video case

Venous arterialisation for no option CLI: Limflow procedure

This case demonstrates the unique Limflow procedure for the so-called 'no option' CLI patients. This term is used for advanced disease with occlusion of the pedal arteries used for distal bypass or angioplasty targets. This 'desert foot' also represents an end-stage pathology that commonly leads to failure of all conventional revascularization attempts. In this video, you will learn the steps of the procedure, all devices needed and important technical tips and tricks for a successful outcome.

June 28, 2018 3 Comments
Recorded video case

Endovascular treatment of a complex case of ischemic diabetic foot syndrome in a chronic kidney disease patient

This case presents a 68-year old dialysis patient with an ischemic diabetic foot. In this video, you will learn about:
(1) the anatomic challenges of diabetic foot syndrome
(2) the decision making in dialysis patients
(3) tips and tricks to cross chronic total occlusions (CTOs)
(4) how to treat the infrapoppliteal vessels and finally
(5) how to interpret the intraoperative angiographic images.

June 11, 2018 3 Comments
Clinical investigation

Validation of the WIfI classification system in nondiabetic patients treated by endovascular means for critical limb ischemia

The WIfI classification system was initially published by Dr. Mills in January 2014 at JVS. The aim of this classification is to stratify the risk of limb amputation (very low, low, moderate and high risk) based on three factors: wound, ischemia and foot infection. The following presentation represents a validation of this classification in a well-defined cohort (nondiabetic patients treated by endovascular means for critical limb ischemia).

June 10, 2018 2 Comments
Recorded video case

Zero contrast atherectomy and endovascular treatment of multi-level femoropopliteal disease

This is a challenging case of a patient with severe claudication due to multi-level disease expanding from the common iliac up to the popliteal artery. The treatment includes the use of directional atherectomy for vessel preparation and DCB as antiproliferative therapy. The whole procedure is performed with CO2-angiography instead of contrast agent in order to avoid acute kidney injury. Learn also the best approach to treat patients with a multi-level disease, i.e. which lesion first.

June 1, 2018 No Comments
Review of the literature

TIPS AND TRICKS FOR FACILITATING TEACHING OF DOPPLER WAVEFORMS AND ANKLE-BRACHIAL-INDEX IN UNDERGRADUATE LEVEL: A PRACTICAL GUIDE

Although the measurement of Ankle-brachial-Index (ABI) is considered a fundamental skill in the diagnosis and assessment of peripheral arterial disease as well as predictive tool for cardiovascular events, real-world practice shows that current teaching and practice in undergraduate medical curricula is far from ideal. this article provides twelve easy-to-follow useful tips to enhance the comprehension and teaching of ABI and favors the simultaneous teaching of Dopler waveform examination.

May 31, 2018 No Comments
Clinical investigation

Heel Wounds Predict Poor Outcomes After Infrapopliteal Revascularization

This study determines whether CLTI patients with heel wounds are at higher risk of mortality, major amputation, or failure to heal their wounds compared to patients with forefoot wounds undergoing revascularization for infrapopliteal arterial disease.

May 28, 2018 No Comments
Clinical investigation

Pedal bypass versus endovascular tibial intervention for ischemic foot wounds

This is a retrospective chart review comparing the outcomes (wound healing rate, patency rate, and amputation-free survival) between pedal bypass and endovascular tibial interventions in 668 limbs of CLTI patients with ischemic wounds and an infrapopliteal intervention.

May 28, 2018 No Comments
Clinical investigation

Drug-Eluting Stent in BTK-arteries – 12 month results of the PREVENT study

12-month results of the PREVENT study, investigating the Promus Element Plus stent system from Boston Scientific in Below-The-Knee arteries.

70 Critical Limb Ischemia patients were enrolled in 5 different sites, divided over Belgium and Germany.

With 12-month Primary Patency rates of 86.2% & freedom of TLR-rates of 93.0%, there is definitely some evidence for Drug-Eluting-Stents in the CLI-BTK area.

May 28, 2018 No Comments
Clinical investigation

Endovascular therapy vs bypass surgery: interim analysis of the CRITISCH registry

This presentation provides an overview of the interim analysis of the CRITISCH registry comparing the endovascular therapy and the bypass surgery as first-line treatments in CLI patients. Original publication: Bisdas et al. JACC Cardiovasc Interv. 2016 Dec 26;9(24):2557-2565.

May 27, 2018 No Comments

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