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  ADVANCES IN BELOW-THE-KNEE MANAGEMENT 

The Journal of Cardiovascular Surgery 2012 April;53(2):223-7

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: English

In lower extremity PTAs intraluminal is better than subintimal

Bosiers M. 1, Deloose K. 2, Callaert J. 1, Maene L. 3, Keirse K. 4, Verbist J. 4, Peeters P. 4

1 Department of Vascular Surgery, A.Z. Sint-Blasius, Dendermonde, Belgium; 2 Department of Vascular Surgery, OLV, Aalst, Belgium; 3 Department of Vascular Surgery, R.Z. Heilig-Hart, Tienen, Belgium; 4 Department of Cardiovascular and Thoracic Surgery, Imelda Hospital, Bonheiden, Belgium


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With subintimal recanalization, a channel is deliberately created by dissecting the vessel wall in order to replace the native occluded lumen. This is opposed to intraluminal recanalization, where passage of an arterial obstructive lesion is performed by central luminal navigation. Both intraluminal and subintimal treatment has its proponents and adversaries. The appreciation of an investigator for a certain technique is commonly related to the training received and the personal experience. Yet, the intraluminal technique uses the clinically preferred route for adjunctive treatment, such as balloon angioplasty or stent deployment. A wide variety of devices designed to obtain intraluminal lesion passage is available and is currently being used in vascular centers worldwide. With intraluminal techniques, success rates of up to 95% have been reported.

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