Salvage of critical limb ischemia with the "trellis reserve'' of subintimal superficial femoral-popliteal artery occlusion: a new modality in managing critical limb ischemia--a case report.
Subintimal angioplasty is a safe, effective, but nondurable procedure in treating long superficial femoral artery occlusions in patients with severe lower limb ischemia. The authors report a case of acute thrombosis that presented 16 weeks after subintimal angioplasty. The ;;Trellis'' percutaneous thrombolytic infusion system permitted a controlled site-specific infusion of recombinant tissue-type plasminogen activator (rtPA). The unique design of the ;;Trellis'' allowed complete aspiration of thrombus and avoiding regional and systemic thrombolytic side effects. The ;;Trellis'' system is effective in percutaneous management of thrombotic lesions; however, intimal dissection may need to be addressed.
Sultan
Sherif
S
Western Vascular Institute, Department of Vascular and Endovascular Surgery, University College Hospital Galway, Ireland. sherifsultan@esatclear.ie
Heskin
Leonie
L
Hynes
Niamh
N
Akhtar
Yousaf
Y
Cough
Val
V
Manning
Brian
B
Aremu
M
M
Courtney
D
D
D000368:Aged; D017130:Angioplasty / Q000009:adverse effects* / Q000379:methods; D000800:Angioplasty, Balloon / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D016638:Critical Illness; D005260:Female; D005263:Femoral Artery; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D018810:Magnetic Resonance Angiography; D011150:Popliteal Artery; D011859:Radiography; D018570:Risk Assessment; D016879:Salvage Therapy; D017131:Thrombectomy / Q000379:methods*; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014654:Vascular Patency
D005343:Fibrinolytic Agents