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Semin intervent Radiol 2014; 31(04): 313-319
DOI: 10.1055/s-0034-1393967
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Treating Calf and Pedal Vessel Disease: The Extremes of Intervention

Marco Manzi
1   Department of Interventional Radiology Unit, Foot and Ankle Clinic, Policlinico Abano Terme, Italy
,
Luis M. Palena
1   Department of Interventional Radiology Unit, Foot and Ankle Clinic, Policlinico Abano Terme, Italy
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Publikationsdatum:
14. November 2014 (online)

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Abstract

Recent developments in catheter, balloon, and guidewire technology have increased the scope for endovascular treatments in the management of complex and challenging disease in the calf and foot. The antegrade femoral approach remains the starting point for most interventions, but there is a growing role for procedures performed from unconventional access such as the pedal arteries. This article reviews the indications for intervention, atypical access, and the choice of equipment for these extreme interventions.

Keywords

below-the-knee - below-the-ankle - angiosome - transpedal - pedal–plantar loop - interventional radiology
 

  • References

  • 1 Faglia E, Clerici G, Clerissi J , et al. Early and five-year amputation and survival rate of diabetic patients with critical limb ischemia: data of a cohort study of 564 patients. Eur J Vasc Endovasc Surg 2006; 32 (5) 484-490
    CrossrefPubMedGoogle Scholar
  • 2 Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG ; TASC II Working Group. Inter-society consensus for the management of peripheral arterial disease (tASC II). J Vasc Surg 2007; 45 (Suppl S): S5-S67
    CrossrefPubMedGoogle Scholar
  • 3 Palena LM, Manzi M. Extreme below-the-knee interventions: retrograde transmetatarsal or transplantar arch access for foot salvage in challenging cases of critical limb ischemia. J Endovasc Ther 2012; 19 (6) 805-811
    CrossrefPubMedGoogle Scholar
  • 4 Adam DJ, Beard JD, Cleveland T , et al; BASIL trial participants. Bypass versus angioplasty in severe ischaemia of the leg (BASIL): multicentre, randomised controlled trial. Lancet 2005; 366 (9501) 1925-1934
    CrossrefPubMedGoogle Scholar
  • 5 Söder HK, Manninen HI, Jaakkola P , et al. Prospective trial of infrapopliteal artery balloon angioplasty for critical limb ischemia: angiographic and clinical results. J Vasc Interv Radiol 2000; 11 (8) 1021-1031
    CrossrefPubMedGoogle Scholar
  • 6 Faglia E, Dalla Paola L, Clerici G , et al. Peripheral angioplasty as the first-choice revascularization procedure in diabetic patients with critical limb ischemia: prospective study of 993 consecutive patients hospitalized and followed between 1999 and 2003. Eur J Vasc Endovasc Surg 2005; 29 (6) 620-627
    CrossrefPubMedGoogle Scholar
  • 7 Dorros G, Jaff MR, Dorros AM, Mathiak LM, He T. Tibioperoneal (outflow lesion) angioplasty can be used as primary treatment in 235 patients with critical limb ischemia: five-year follow-up. Circulation 2001; 104 (17) 2057-2062
    CrossrefPubMedGoogle Scholar
  • 8 Romiti M, Albers M, Brochado-Neto FC, Durazzo AE, Pereira CA, De Luccia N. Meta-analysis of infrapopliteal angioplasty for chronic critical limb ischemia. J Vasc Surg 2008; 47 (5) 975-981
    CrossrefPubMedGoogle Scholar
  • 9 Schmidt A, Ulrich M, Winkler B , et al. Angiographic patency and clinical outcome after balloon-angioplasty for extensive infrapopliteal arterial disease. Catheter Cardiovasc Interv 2010; 76 (7) 1047-1054
    CrossrefPubMedGoogle Scholar
  • 10 Kawarada O, Fujihara M, Higashimori A, Yokoi Y, Honda Y, Fitzgerald PJ. Predictors of adverse clinical outcomes after successful infrapopliteal intervention. Catheter Cardiovasc Interv 2012; 80 (5) 861-871
    CrossrefPubMedGoogle Scholar
  • 11 Rocha-Singh KJ, Jaff M, Joye J, Laird J, Ansel G, Schneider P ; VIVA Physicians. Major adverse limb events and wound healing following infrapopliteal artery stent implantation in patients with critical limb ischemia: the XCELL trial. Catheter Cardiovasc Interv 2012; 80 (6) 1042-1051
    CrossrefPubMedGoogle Scholar
  • 12 Bosiers M, Deloose K, Callaert J , et al. 4-French-compatible endovascular material is safe and effective in the treatment of femoropopliteal occlusive disease: results of the 4-EVER trial. J Endovasc Ther 2013; 20 (6) 746-756
    CrossrefPubMedGoogle Scholar
  • 13 Narins CR. Access strategies for peripheral arterial intervention. Cardiol J 2009; 16 (1) 88-97
    PubMedGoogle Scholar
  • 14 Gandini R, Pipitone V, Stefanini M , et al. The “Safari” technique to perform difficult subintimal infragenicular vessels. Cardiovasc Intervent Radiol 2007; 30 (3) 469-473
    CrossrefPubMedGoogle Scholar
  • 15 Rogers RK, Dattilo PB, Garcia JA, Tsai T, Casserly IP. Retrograde approach to recanalization of complex tibial disease. Catheter Cardiovasc Interv 2011; 77 (6) 915-925
    CrossrefPubMedGoogle Scholar
  • 16 Fusaro M, Agostoni P, Biondi-Zoccai G. “Trans-collateral” angioplasty for a challenging chronic total occlusion of the tibial vessels: a novel approach to percutaneous revascularization in critical lower limb ischemia. Catheter Cardiovasc Interv 2008; 71 (2) 268-272
    CrossrefPubMedGoogle Scholar
  • 17 Manzi M, Fusaro M, Ceccaci T, Erente G, Dalla Paola L, Brocco E. Clinical results of below-the-knee interventions using pedal-plantar loop technique. J Cardiovasc Surg (Torino) 2009; 50: 331-337
    PubMedGoogle Scholar
  • 18 Graziani L, Silvestro A, Bertone V , et al. Vascular involvement in diabetic subjects with ischemic foot ulcer: a new morphologic categorization of disease severity. Eur J Vasc Endovasc Surg 2007; 33 (4) 453-460
    CrossrefPubMedGoogle Scholar
  • 19 Peregrin JH, Koznar B, Kovác J , et al. PTA of infrapopliteal arteries: long-term clinical follow-up and analysis of factors influencing clinical outcome. Cardiovasc Intervent Radiol 2010; 33 (4) 720-725
    CrossrefPubMedGoogle Scholar
  • 20 Manzi M, Cester G, Palena LM, Alek J, Candeo A, Ferraresi R. Vascular imaging of the foot: the first step toward endovascular recanalization. Radiographics 2011; 31 (6) 1623-1636
    CrossrefPubMedGoogle Scholar
  • 21 Attinger CE, Evans KK, Bulan E, Blume P, Cooper P. Angiosomes of the foot and ankle and clinical implications for limb salvage: reconstruction, incisions, and revascularization. Plast Reconstr Surg 2006; 117 (7, Suppl): 261S-293S
    CrossrefPubMedGoogle Scholar
  • 22 Neville RF, Attinger CE, Bulan EJ, Ducic I, Thomassen M, Sidawy AN. Revascularization of a specific angiosome for limb salvage: does the target artery matter?. Ann Vasc Surg 2009; 23 (3) 367-373
    CrossrefPubMedGoogle Scholar
  • 23 Iida O, Nanto S, Uematsu M , et al. Importance of the angiosome concept for endovascular therapy in patients with critical limb ischemia. Catheter Cardiovasc Interv 2010; 75 (6) 830-836
    PubMedGoogle Scholar
  • 24 Alexandrescu V, Hubermont G. The challenging topic of diabetic foot revascularization: does the angiosome-guided angioplasty may improve outcome. J Cardiovasc Surg (Torino) 2012; 53 (1) 3-12
    PubMedGoogle Scholar
  • 25 Alexandrescu V, Söderström M, Venermo M. Angiosome theory: fact or fiction?. Scand J Surg 2012; 101 (2) 125-131
    CrossrefPubMedGoogle Scholar
  • 26 Varela C, Acín F, de Haro J, Bleda S, Esparza L, March JR. The role of foot collateral vessels on ulcer healing and limb salvage after successful endovascular and surgical distal procedures according to an angiosome model. Vasc Endovascular Surg 2010; 44 (8) 654-660
    CrossrefPubMedGoogle Scholar
  • 27 Azuma N, Uchida H, Kokubo T, Koya A, Akasaka N, Sasajima T. Factors influencing wound healing of critical ischaemic foot after bypass surgery: is the angiosome important in selecting bypass target artery?. Eur J Vasc Endovasc Surg 2012; 43 (3) 322-328
    CrossrefPubMedGoogle Scholar
  • 28 Manzi M, Palena LM. Retrograde percutaneous transmetatarsal artery access: new approach for extreme revascularization in challenging cases of critical limb ischemia. Cardiovasc Intervent Radiol 2013; 36 (2) 554-557
    CrossrefPubMedGoogle Scholar
  • 29 Fusaro M, Dalla Paola L, Biondi-Zoccai GG. Retrograde posterior tibial artery access for below-the-knee percutaneous revascularization by means of sheathless approach and double wire technique. Minerva Cardioangiol 2006; 54 (6) 773-777
    PubMedGoogle Scholar
  • 30 Fusaro M, Dalla Paola L, Biondi-Zoccai G. Pedal-plantar loop technique for a challenging below-the-knee chronic total occlusion: a novel approach to percutaneous revascularization in critical lower limb ischemia. J Invasive Cardiol 2007; 19 (2) E34-E37
    PubMedGoogle Scholar
  • 31 Katsanos K, Diamantopoulos A, Spiliopoulos S, Karnabatidis D, Siablis D. Below-the-ankle angioplasty and stenting for limb salvage: anatomical considerations and long-term outcomes. Cardiovasc Intervent Radiol 2013; 36 (4) 926-935
    CrossrefPubMedGoogle Scholar
  • 32 Fusaro M, Tashani A, Mollichelli N, Medda M, Inglese L, Biondi-Zoccai GG. Retrograde pedal artery access for below-the-knee percutaneous revascularisation. J Cardiovasc Med (Hagerstown) 2007; 8 (3) 216-218
    CrossrefPubMedGoogle Scholar
  • 33 Montero-Baker M, Schmidt A, Bräunlich S , et al. Retrograde approach for complex popliteal and tibioperoneal occlusions. J Endovasc Ther 2008; 15 (5) 594-604
    CrossrefPubMedGoogle Scholar
  • 34 Rogers RK, Dattilo PB, Garcia JA, Tsai T, Casserly IP. Retrograde approach to recanalization of complex tibial disease. Catheter Cardiovasc Interv 2011; 77 (6) 915-925
    CrossrefPubMedGoogle Scholar
  • 35 Manzi M, Palena L, Cester G. Endovascular techniques for limb salvage in diabetics with crural and pedal disease. J Cardiovasc Surg (Torino) 2011; 52 (4) 485-492
    PubMedGoogle Scholar
  • 36 Londoño JC, Singh V, Martinez CA. Posterior tibial artery access using transradial techniques: retrograde approach to inaccessible lower extremity lesions. Catheter Cardiovasc Interv 2012; 79 (7) 1194-1198
    CrossrefPubMedGoogle Scholar
  • 37 Spinosa DJ, Harthun NL, Bissonette EA , et al. Subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) for subintimal recanalization to treat chronic critical limb ischemia. J Vasc Interv Radiol 2005; 16 (1) 37-44
    CrossrefPubMedGoogle Scholar
  • 38 Roguin A, Goldstein J, Bar O. Brain tumours among interventional cardiologists: a cause for alarm? Report of four new cases from two cities and a review of the literature. EuroIntervention 2012; 7 (9) 1081-1086
    CrossrefPubMedGoogle Scholar