The Effect of Stenting on Patency and Limb Salvage in Cases of TASC D Femoropopliteal Disease in Critical Limb Ischemia
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- Category: Vol. 84, September 2016
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The Effect of Stenting on Patency and Limb Salvage in Cases of TASC D Femoropopliteal Disease in Critical Limb Ischemia, HASSAN A. SOLIMAN, MOHAMED I. EL-MAADAWY, AHMED M. ALMAHROUKY and MOHAMED A. ABDRABOU
Abstract
The aim was to evaluate the effect of stenting on patency and limb salvage in cases of TASC D femoropopliteal disease in critical limb ischemia patients.
This prospective study included 51 patients presented to the Vascular Surgery Department in Kasr Al-Aini and New Kasr Al-Aini Teaching Hospitals with femoropopliteal disease for whom endovascular revascularization was done, between January 2013 and January 2014.
Patients and Methods: Angiography was performed under systemic heparin administration (5000 IU) through the sheath. SIA, trying to achieve re-entry. If reentry was not successful, a transpopliteal approach is used and if still reentry was not successful a reentry device is used.
Once the lesion is crossed, the guiding catheter is ex-changed for a 5- or 6-mm-diameter 5-French balloon catheter. Refractory stenoses may require placement of Self-Expandable Peripheral Nitinol Stents in the affected region. During the procedure, a systemic 1000 IU Heparin was given per hour.
Clinical follow-up and duplex examination at 1 month, 6 months, and 12 months after the procedure were done. It included follow-up of pulse examination, evaluation of the claudication pain and rest pain, evaluation of ulcer or ampu-tation site healing or resolution of infection.
Results: Technical success was achieved in 90.2% of patients who underwent endovascular of TASCD lesions. Patients who underwent failed attempts at endovascular intervention for a TASC D lesion were not included in the subsequent outcomes analysis. Seventeen limbs (31.3%) required an ante grade approach to facilitate successful reca-nalization.
Follow-up length was 12 months excluding five patients who were technically failed one patient who expired in the hospital one week post oprative. Another one died during follow-up.
There were 26.5% major amputations during the follow-up 14.3% in the firest three months post operative. 18.4% above knee amputation 4.1% below knee amputation 4.1%