Abstract:
Chronic limb-threatening ischemia due to chronic total occlusion of below-the-knee lesions is one of the most challenging cases for endovascular treatment. Restoring perfusion is crucial, and its success depends on numerous factors. Owing to the recent development of dedicated devices and techniques, endovascular treatment is becoming an alternative to bypass surgery as a first-line treatment, even for the infra-popliteal lesion, because endovascular recanalization outcomes have considerably improved. In our present case, a self-expandable Nitinol stent was placed in the tibio-peroneal trunk to treat chronic limb-threatening ischemia. At its recurrence four years later, endovascular therapy was employed because the patient had concomitant diseases and advanced age. Finally, four times repeated revascularization prevented major amputation and preserved the functional foot. This report demonstrates that repeated endovascular therapy was practical and feasible to achieve limb salvage and preserve the functional foot.
摘要:
由于膝下病变的慢性完全闭塞引起的慢性威胁肢体缺血是血管内治疗最具挑战性的病例之一。恢复灌注至关重要,它的成功取决于许多因素。由于专用设备和技术的最新发展,作为一线治疗,血管内治疗正在成为旁路手术的替代方案,即使是对于the下病变,因为血管内再通结局有了相当大的改善.在我们目前的情况下,我们在胫腓骨干放置了一个自膨式镍钛诺支架,用于治疗慢性威胁肢体缺血.四年后复发,采用血管内治疗是因为患者有合并疾病和高龄.最后,重复四次血运重建可防止严重截肢并保留功能性足。该报告表明,重复的血管内治疗对于实现肢体挽救和保留功能性足是可行的。