| Sub-title | |
| Authors | Anthony Zammit Michael Micallef |
| Abstract | Transluminal angioplasty is a technique which has been practiced extensively locally. Femoral, iliac, renal and visceral angioplasty have all been approached with satisfactory results. Currently with advance in technology and improvements in the technique of angioplasty a trial is ongoing for the popliteal artery and the smaller arteries of the legs in acute lower limb ischaemia. Transluminal angioplasty was practiced in stenotic arterial disease by passing guide wires through the lumen followed by high pressure balloon catheters. Eventually, short segment occlusions were also tackled by pushing guidewire/catheter combination through atheromatous occlusions. Lately, floppy hydrophilic guidewires are being channelled subintimally through long segment occlusions in ileo-femoral regions. This has been extended to the popliteal-tibial regions in grossly diseased vessels in acute limb threatening ischaemia commonly in diabetics for limb salvage techniques. The best results are obtained in the single stenotic lesion which is easily crossed and readily dilated. Difficulties encountered depend on: 1) presence of arterial calcification in diabetes and renal disease as this limits dilation. 2) presence of occlusions which can be impossible to traverse depending on timing of presentation (with late presentation being harder to cross). 3) presence of long segments or multiple segments of stenoses which present large atheromatous bulk which is more difficult to control well without elastic recoil leading to restenosis. The discussion will include arterial anatomy, classification of disease and indications for the technique. The work up, in and post-procedural therapy and angioplasty technique with results and complications will be elaborated. Our experience in this new technique is building up and Subintimal Popliteal-Tibial Angioplasty is promising and merits further extension with extension into popliteal-tibial stenting in future. |
Published in: | |
| Journal | Malta Medical Journal |
| Volume | Volume 15 (suppl) |
| Pages | - |
| Date | |
| Link to journal | |
| Key words | popliteal-tibial, angioplasty, surgery, outcome |