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Bifurcated Stent May Provide Option for Below-the-Knee Angioplasty
A bifurcated stent for below-the-knee infrapopliteal percutaneous transluminal angioplasty in selected patients with critical limb ischemia was associated with high rates of technical success, early and midterm patency and clinical improvement, results from a small cohort study have shown.
Researchers assessed the Nile Croco coronary bifurcated stent (Minvasys) in 31 patients with below-the-knee TransAtlantic Inter-Society Consensus C and D lesions at the popliteal (n=17; 54.8%) and distal tibioperoneal trunk (n=14; 45.2%) from October 2006 to December 2010. All patients achieved technical success without intraoperative complications. Early complications included an acute stent occlusion and an acute compartment syndrome for a collateral arterial branch perforation.
Median follow-up was 12.1 months. At 30 days, primary patency was 96.7% and secondary patency was 86.2% (95% CI, 67.2-94.6). At 1 year, primary patency was 100% and secondary patency was 96.6% (95% CI, 78-99.5).
Twenty-eight patients (90.3%) achieved an upward shift of at least two Rutherford categories and one patient required a major amputation. Overall limb salvage at 1 year was 96.7% (95% CI, 78.6-99.5).
“Despite issues linked to a learning curve, this study reports results at 1 year that are comparable to, if not more advantageous than, those reported in literature for in-line arterial flow [below-the-knee] stenting,” researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.