title: [Retrograde subintimal angioplasty for treatment of occlusive diseases in the long segment of the infrapopliteal artery].
abstract: OBJECTIVE
  To assess the clinical efficacy of retrograde puncture subintimal angioplasty (SIA) for treatment of occlusive diseases in the long segment of the infrapopliteal artery.
  
  
  METHODS
  The clinical data of 50 patients with occlusive diseases in the long segment of the infrapopliteal artery were retrospectively analyzed. The patients were divided into control group (n=25) and study group (n=25) and received antegrade SIA and retrograde puncture SIA with long balloon after the failed antegrade SIA, respectively. The ankle brachial index (ABI) and the temperature of the infrapopliteal skin before and after the operation were compared between the two groups.
  
  
  RESULTS
  The technical success rate was 100% in the 50 patients, who showed obviously improved ischemic symptoms without serious complications. The ABI of the study group increased from 0.31 ± 0.12 before the treatment to 0.47 ± 0.09 at 24 h, 0.56 ± 0.06 at 1 week, 0.63 ± 0.07 at 3 months, 0.58 ± 0.06 at 6 months, and 0.49 ± 0.03 at 12 months after the treatment, and the skin temperature increased from 28.13 ± 2.45 before the operation to 33.87 ± 1.24, 34.16 ± 0.44, 34.19 ± 0.25, 32.45 ± 0.25, and 31.05 ± 0.21 at the corresponding time points after the treatment, respectively, showing significant improvements after the operation (P<0.05). ABI, skin temperature and the patency rate were similar between the two groups at each of the postoperative time points (P>0.05).
  
  
  CONCLUSIONS
  Retrograde puncture SIA is safe and effective for treatment of arteriosclerosis obliterans in the infrapopliteal arteries with a high clinical success rate and a low complication rate after the failure of antegrade SIA.
authors.affiliation: 1Department of Radiology, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing 210006, China; 3Department of Radiology, Jiangbei People's Hospital, Nanjing 210048, China. E-mail: szf1211@sina.com.
authors.forename: Zefeng
authors.initials: Z
authors.lastname: Shao
authors.forename: Zizheng
authors.initials: Z
authors.lastname: Wang
authors.forename: Jianping
authors.initials: J
authors.lastname: Gu
authors.forename: Xu
authors.initials: X
authors.lastname: He
authors.forename: Wensheng
authors.initials: W
authors.lastname: Lou
authors.forename: Liang
authors.initials: L
authors.lastname: Chen
authors.forename: Guoping
authors.initials: G
authors.lastname: Chen
authors.forename: Jinhua
authors.initials: J
authors.lastname: Song
authors.forename: Guopin
authors.initials: G
authors.lastname: Wang
mesh_terms: D017130:Angioplasty; D055109:Ankle Brachial Index; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D005263:Femoral Artery / Q000473:pathology; D006801:Humans; D011150:Popliteal Artery / Q000473:pathology; D012189:Retrospective Studies