Interventions in Below-the-Knee Lesions in Critical Limb Ischemia

Jose M. Wiley, Prakash Krishnan, Arthur Tarricone

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

For patients with intermittent claudication (IC), approximately 20% will have progressive symptoms and 1-2% will develop critical limb ischemia (CLI) within 5 years and a 1-year mortality rate of about 20% in several series. This chapter discusses the following endovascular techniques that have been used for recanalization of the infrapopliteal arteries: balloon angioplasty; drug-eluting balloon angioplasty; cryotherapy; bare metal and drug-eluting stent placement; and adjunctive interventions. Specialized cryoplasty balloon catheters are inflated not with the standard mixture of saline solution and contrast medium but rather with nitrous oxide. Stent placement for infrapopliteal disease has gained progressive attention. The proven efficacy of drug-coated stents in the treatment of coronary artery disease gave rise to the notion that they might have a better patency compared to bare metal stents (BMS) in small infrapopliteal vessels. Atherectomy devices are designed to debulk and remove atherosclerotic plaque by cutting, pulverizing, or shaving with catheter-deliverable blades.

Original languageEnglish (US)
Title of host publicationUrgent Interventional Therapies
PublisherWiley Blackwell
Pages338-347
Number of pages10
ISBN (Electronic)9781118504499
ISBN (Print)9780470672020
DOIs
StatePublished - Nov 17 2014
Externally publishedYes

Fingerprint

Drug-Eluting Stents
Balloon Angioplasty
Stents
Knee
Ischemia
Catheters
Extremities
Metals
Atherectomy
Intermittent Claudication
Endovascular Procedures
Cryotherapy
Nitrous Oxide
Atherosclerotic Plaques
Sodium Chloride
Contrast Media
Coronary Artery Disease
Arteries
Equipment and Supplies
Mortality

Keywords

  • Balloon angioplasty
  • Bare metal stents (BMS)
  • Below-the-knee lesions
  • Critical limb ischemia
  • Cryotherapy
  • Drug-eluting balloon angioplasty
  • Excisional atherectomy
  • Intermittent claudication (IC)

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Wiley, J. M., Krishnan, P., & Tarricone, A. (2014). Interventions in Below-the-Knee Lesions in Critical Limb Ischemia. In Urgent Interventional Therapies (pp. 338-347). Wiley Blackwell. https://doi.org/10.1002/9781118504499.ch39

Interventions in Below-the-Knee Lesions in Critical Limb Ischemia. / Wiley, Jose M.; Krishnan, Prakash; Tarricone, Arthur.

Urgent Interventional Therapies. Wiley Blackwell, 2014. p. 338-347.

Research output: Chapter in Book/Report/Conference proceedingChapter

Wiley, JM, Krishnan, P & Tarricone, A 2014, Interventions in Below-the-Knee Lesions in Critical Limb Ischemia. in Urgent Interventional Therapies. Wiley Blackwell, pp. 338-347. https://doi.org/10.1002/9781118504499.ch39
Wiley JM, Krishnan P, Tarricone A. Interventions in Below-the-Knee Lesions in Critical Limb Ischemia. In Urgent Interventional Therapies. Wiley Blackwell. 2014. p. 338-347 https://doi.org/10.1002/9781118504499.ch39
Wiley, Jose M. ; Krishnan, Prakash ; Tarricone, Arthur. / Interventions in Below-the-Knee Lesions in Critical Limb Ischemia. Urgent Interventional Therapies. Wiley Blackwell, 2014. pp. 338-347
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