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Vascular access in critical limb ischemia. [Review]

by Kang, Won Yu; Campia, Umberto; Ota, Hideaki; Didier, Romain J; Negi, Smita I; Kiramijyan, Starkis; Koifman, Edward; Baker, Nevin C; Magalhaes, Marco A; Lipinski, Michael J; Escarcega, Ricardo O; Torguson, Rebecca; Waksman, Ron; Bernardo, Nelson L.
Citation: Cardiovascular Revascularization Medicine. 17(3):190-8, 2016 Apr-May.Journal: Cardiovascular revascularization medicine : including molecular interventions.Published: 2016ISSN: 1878-0938.Full author list: Kang WY; Campia U; Ota H; Didier RJ; Negi SI; Kiramijyan S; Koifman E; Baker NC; Magalhaes MA; Lipinski MJ; Escarcega RO; Torguson R; Waksman R; Bernardo NL.UI/PMID: 27157294.Subject(s): Catheterization, Peripheral/ae [Adverse Effects] | *Catheterization, Peripheral/mt [Methods] | Critical Illness | Endovascular Procedures/ae [Adverse Effects] | *Endovascular Procedures/mt [Methods] | Femoral Artery/dg [Diagnostic Imaging] | *Femoral Artery | Humans | Ischemia/dg [Diagnostic Imaging] | Ischemia/pp [Physiopathology] | *Ischemia/th [Therapy] | Limb Salvage | Peripheral Vascular Diseases/di [Diagnosis] | Peripheral Vascular Diseases/pp [Physiopathology] | *Peripheral Vascular Diseases/th [Therapy] | Punctures | Radiography, Interventional | Risk Factors | Time Factors | Treatment Outcome | Vascular PatencyInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal Article | ReviewDigital Object Identifier: https://dx.doi.org/10.1016/j.carrev.2016.02.001 (Click here) Abbreviated citation: Cardiovasc Revasc Med. 17(3):190-8, 2016 Apr-May.Local Holdings: Available in print through MWHC library: 2002 - present.Abstract: Currently, percutaneous endovascular intervention is considered a first line of therapy for treating patients with critical limb ischemia. As the result of remarkable development of techniques and technologies, percutaneous endovascular intervention has led to rates of limb salvage comparable to those achieved with bypass surgery, with fewer complications, even in the presence of lower rates of long-term patency. Currently, interventionalists have a multiplicity of access routes including smaller arteries, with both antegrade and retrograde approaches. Therefore, the choice of the optimal access site has become an integral part of the success of the percutaneous intervention. By understanding the technical aspects, as well as the advantages and limitations of each approach, the interventionalists can improve clinical outcomes in patients with severe peripheral arterial disease. This article reviews the access routes in critical limb ischemia, their advantages and disadvantages, and the clinical outcomes of each. Abstract: Copyright © 2016 Elsevier Inc. All rights reserved.

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