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Online ISSN 1827-1847
INNOVATIONS IN BTK TREATMENT
Waters E. 1, Bolia A. 2
1 Department of Imaging Leicester Royal Infirmary, Leicester, UK;
2 Department of Imaging Leicester Royal Infirmary, Leicester, UK
Subintimal angioplasty was pioneered 25 years ago and has been widely used to treat symptomatic lower limb arterial occlusive disease. The technique creates a dissection in the subintimal plane, thereby bypassing an intraluminal occluded segment, with subsequent balloon dilatation of this new disease-free tract. It has not been until more recently that this technique has been applied to below the knee disease, with recanalization of long tibial occlusions and reconstitution of the trifurcation possible. Subintimal angioplasty is a safe, effective and minimally invasive procedure, with good technical success and consistently high limb salvage rates. Patients who are high risk or unsuitable for surgical limb salvage can be successfully treated with subintimal angioplasty and the technique is now considered first line therapy in the management of lower limb ischemia in many centres.