Clinical utility of 3 French infrapopliteal intervention in the setting of critical limb ischemia.
OBJECTIVE
To evaluate the clinical utility of 3 Fr infrapopliteal intervention in critical limb ischemia (CLI) patients with isolated infrapopliteal artery disease (IPD).


BACKGROUND
There is considerable scope for the miniaturization of infrapopliteal intervention in the clinical field.


METHODS
In this study, 3 Fr infrapopliteal intervention was performed in a total of 11 consecutive patients and limbs, selected by operator judgment on the basis of the clinical and angiographical conditions of the patients. The 3 Fr sheath was removed immediately after the completion of the procedure in the cath lab. After manual compression for 5 minutes (min), a compressive dressing was applied for 30 min.


RESULTS
Among the subjects, a poor general condition was observed in 3 patients, while end-stage renal disease was observed in 9. Technical success was achieved in all cases except for 1 case in which the limb of the patient required 4 Fr sheath for coronary stenting for the flow-limiting tibial dissection. In all the patients undergoing 3 Fr intervention, complete hemostasis was achieved simply without any complication. Skin perfusion pressure of the foot significantly increased at both the dorsum and plantar. Further, clinical success was achieved in all patients.


CONCLUSIONS
This study showed that 3 Fr infrapopliteal intervention is safe and feasible for selected CLI patients with isolated IPD. In particular, the benefits offered by this miniaturized intervention from the aspect of the comfort of patients can be potentially of considerable value in the setting of CLI; however, this intervention requires further validation.
Kawarada
Osami
O
Division of Cardiovascular Medicine, Stanford University Medical Center, 300 Pasteur Drive, Room H3554, Stanford, CA, 94305-5637, USA. kawarada@stanford.edu
D000368:Aged; D000792:Angiography; D000800:Angioplasty, Balloon / Q000295:instrumentation / Q000379:methods; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006801:Humans; D007511:Ischemia / Q000628:therapy; D007866:Leg / Q000098:blood supply*; D023821:Limb Salvage / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000503:physiopathology / Q000628:therapy*; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012039:Regional Blood Flow / Q000502:physiology; D012189:Retrospective Studies