PMID- 32589120
OWN - NLM
STAT- MEDLINE
DCOM- 20201102
LR  - 20201102
IS  - 1545-1550 (Electronic)
IS  - 1526-6028 (Linking)
VI  - 27
IP  - 4
DP  - 2020 Aug
TI  - Intravascular Ultrasound-Guided Interventions for Below-the-Knee Disease in 
      Patients With Chronic Limb-Threatening Ischemia.
PG  - 565-574
LID - 10.1177/1526602820935606 [doi]
AB  - Purpose: To assess the utility of intravascular ultrasound (IVUS) during 
      below-the-knee (BTK) interventions for patients with chronic limb-threatening 
      ischemia (CLTI). Materials and Methods: This retrospective single-center study 
      included 216 symptomatic patients (mean age 74.2+/-9.5 years; 167 men) with CLTI 
      and BTK steno-occlusive disease who underwent successful balloon angioplasty 
      between January 2016 and August 2018. Data from 88 vessels (58 patients) treated 
      with IVUS-guided procedures were compared with corresponding values from 242 
      vessels (158 patients) treated with angiography-guided procedures. The primary 
      outcomes included procedure-related variables of balloon size, contrast dose, and 
      complication rates, as well as changes in ankle-brachial index (ABI) and skin 
      perfusion pressure (SPP). Secondary outcomes included IVUS determination of 
      vessel size, wire route, and calcification severity, as well as technical success 
      and clinically-driven target lesion revascularization (TLR), limb salvage, and 
      wound healing rates in the Rutherford category 5/6 patients as evaluated by 
      propensity score matching analysis. Results: The patient and lesion 
      characteristics were similar in both groups. The mean balloon size for 
      IVUS-guided procedures was significantly larger (2.45+/-0.4 mm) compared with that 
      for angiography-guided procedures (2.23+/-0.4 mm; p<0.001). The technical success 
      (p=0.56) and complication rates (p=0.16) were similar between the groups. The 
      postprocedure dorsal and plantar SPP and change in dorsal SPP improved more in 
      the IVUS-guided group (p<0.001, p=0.015, and p=0.02, respectively). The 
      IVUS-guided group had a significantly better wound healing rate than the 
      angiography-guided group (p=0.006), although the freedom from TLR and limb 
      salvage rates were similar between the groups (p=0.16 and p>0.99, respectively). 
      Conclusion: IVUS-guided interventions for BTK lesions were safe and effective in 
      accurately assessing the lesions. The results suggest that IVUS guidance of 
      endovascular procedures has the potential to influence better clinical outcomes 
      than angiography-guided angioplasty.
FAU - Fujihara, Masahiko
AU  - Fujihara M
AUID- ORCID: 0000-0002-7001-9220
AD  - Department of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada, Japan.
AD  - Department of Medicine and Biosystemic Science, Kyushu University Graduate School 
      of Medical Sciences, Fukuoka, Japan.
FAU - Yazu, Yuko
AU  - Yazu Y
AD  - Department of Medical Engineering, Kishiwada Tokushukai Hospital, Kishiwada, 
      Japan.
FAU - Takahara, Mitsuyoshi
AU  - Takahara M
AD  - Department of Diabetes Care Medicine, Osaka University Graduate School of 
      Medicine, Osaka, Japan.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20200626
PL  - United States
TA  - J Endovasc Ther
JT  - Journal of endovascular therapy : an official journal of the International 
      Society of Endovascular Specialists
JID - 100896915
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Angioplasty, Balloon/adverse effects/instrumentation
MH  - Chronic Disease
MH  - Female
MH  - Humans
MH  - Ischemia/diagnostic imaging/physiopathology/*therapy
MH  - Leg/*blood supply
MH  - Limb Salvage
MH  - Male
MH  - Middle Aged
MH  - Peripheral Arterial Disease/diagnostic imaging/physiopathology/*therapy
MH  - Predictive Value of Tests
MH  - *Radiography, Interventional/adverse effects
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
MH  - *Ultrasonography, Interventional/adverse effects
MH  - Vascular Patency
MH  - Wound Healing
OTO - NOTNLM
OT  - angiography
OT  - angioplasty
OT  - below-the-knee arteries
OT  - chronic limb-threatening ischemia
OT  - endovascular therapy
OT  - intravascular ultrasound
OT  - limb salvage
OT  - peripheral artery disease
OT  - wound healing
EDAT- 2020/06/27 06:00
MHDA- 2020/11/03 06:00
CRDT- 2020/06/27 06:00
PHST- 2020/06/27 06:00 [pubmed]
PHST- 2020/11/03 06:00 [medline]
PHST- 2020/06/27 06:00 [entrez]
AID - 10.1177/1526602820935606 [doi]
PST - ppublish
SO  - J Endovasc Ther. 2020 Aug;27(4):565-574. doi: 10.1177/1526602820935606. Epub 2020 
      Jun 26.