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A Journal on Heart and Vascular Diseases

Official Journal of the Italian Society of Angiology and Vascular Pathology
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Minerva Cardioangiologica 2009 February;57(1):117-29

language: English

Update management below knee intervention

Bosiers M. 1, Deloose K. 1, Verbist J. 2, Peeters P. 2

1 Department of Vascular Surgery AZ St-Blasius, Dendermonde, Belgium
2 Department of Cardiovascular and Thoracic Surgery Imelda Hospital, Bonheiden, Belgium


The application of percutaneous techniques for the treatment of peripheral arterial occlusive disease (PAOD) has gained widespread interest over the last decade. Together with the development of new endovascular tools and with an increasing operator experience, the minimal invasive percutaneous therapy became first line therapy at many institutions. Patients with critical limb ischemia (CLI) due to infrapopliteal lesions are often no good candidates infrageniculate bypass surgery (IBS), as they often present with prohibitive comorbidities, inadequate conduit, and lack of suitable distal targets for revascularization. Therefore, CLI patients due to blockage of below-the-knee (BTK) arteries are in benefit of the endovascular approach: it offers the advantages of local anesthesia, potentially reduced costs (even anticipating the need for reintervention in many patients), shorter hospital stays The current article provides an overview of the diagnosis and endovascular treatment strategies for infrapopliteal lesions in patients with CLI and gives recommendations for future infrapopliteal device technology advancements.

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