Aim. To evaluate the feasibility of treating critical limb ischaemia in patients with infrainguinal obstruction using 4 Fr sheaths with femoral anterograde access. Methods. From 01.01.2007 to 31.03.2009 641 patients with critical ischaemia underwent 785 endovascolar revasculariza-tion procedures. (males: 442 females:199 ; median age 71.6 years ± 11 years ). All patients presented with at least 3 major cardiovascular risk-factors (chronic ischemic heart disease, arterial hypertension, diabetes mellitus, chronic renal failure); 52 procedures were undertaken for the presence of pain at rest and 733 for the presence of ischemic trophic lesions. Anterograde femoral access was used in 713 cases (91%) while the contralateral femoral access was performed in 72 procedures (9%). A 4 Fr sheath was used in 672 procedures (95%); in 37 procedures (5%) it was necessary to change to a sheath of larger diameter (8 patients 5 Fr, 25 Fr 6 patients, 1 patient 7 Fr, 3 Patients 8 Fr) to perform a thromboaspiration in 8 cases, mechanic aterectomy in 1 case, and where placement of 4 Fr sheath stents were not compatible in 28 cases. Results. The immediate technical success obtained in 770 procedures was 98% and the limb salvage rate was 86% at 24 months. There were no major complications.There were 14 minor post-procedurale complications (2%), of which 12 inguinal haematomas and 2 pseudoaneurysms that required corrective surgery (0.3%). Conclusions.The rate of re-do endovascular procedures for recurrence of critical limb ischemia in the same limb was 9.4% at 2 years with an average of 6.6 ± 5.5 months after the initial procedure.
|Titolo:||Anterograde femoral artery access with 4 french sheath : single centre experience in 641 patients with critical limb ischemia|
|Settore Scientifico Disciplinare:||Settore MED/22 - Chirurgia Vascolare|
|Data di pubblicazione:||set-2010|
|Appare nelle tipologie:||01 - Articolo su periodico|