Techniques for Infrapopliteal Arterial Bifurcation Stenting.

Authors :: Kok HK
Prabhudesai SG
Ahmed I
Karunanithy N
Abisi S
Katsanos K
Diamantopoulos A
Source :: Annals of vascular surgery [Ann Vasc Surg] 2018 Jul; Vol. 50, pp. 288-296. Date of Electronic Publication: 2018 Mar 05.
Publication Year :: 2018
Abstract: Background: Endovascular treatment of infrapopliteal peripheral arterial disease (PAD) is an established and effective treatment strategy for patients with symptomatic PAD. Increasingly, complex infrapopliteal lesions are treated with an endovascular first approach, especially in the setting of critical limb ischemia (CLI) for limb salvage, avoiding major amputations which impact on mobility and quality of life. However, many complex infrapopliteal lesions involving the bifurcation of the tibial arteries remain challenging to treat because of recoil or acute dissection after angioplasty and may require stenting using specialized techniques.<br />Methods and Results: We illustrated techniques for infrapopliteal arterial bifurcation stenting using case-based examples. The techniques covered include the single-stent, culottes, kissing, crush, and T-stenting techniques, and each is considered based on individual strengths and limitations.<br />Conclusions: Infrapopliteal bifurcation stenting allows complex bifurcation lesions to be treated effectively when flow-limiting complications are encountered after angioplasty.<br /> (Copyright © 2018 Elsevier Inc. All rights reserved.)