Below-the-Knee Endovascular Revascularization: A Position Statement (JACC Cardiovascular Interventions March 2024)-Article: Below-the-Knee Endovascular Revascularization: A Position Statement

Article: Below-the-Knee Endovascular Revascularization: A Position Statement

Pdf Summary

The document is a comprehensive review of endovascular revascularization techniques for patients suffering from chronic limb-threatening ischemia (CLTI). It emphasizes the importance of proper patient selection, proficiency in endovascular techniques, and a collaborative approach among medical specialties to prevent major amputations and promote wound healing in CLTI patients. Various challenges in Below-the-Knee (BTK) revascularization, such as vessel sizing, lesion characteristics, and complications like perforations and embolization, are discussed along with strategies for their management. The review provides guidance on efficient crossing of BTK lesions, wire selection strategies, and treatment options for nondilatable lesions. Post-treatment assessment importance for ensuring revascularization success is highlighted. Additionally, the document explores various techniques and treatments used for CLTI management, including balloon angioplasty, stent graft implantation, and surgical interventions, underscoring the need for a multidisciplinary approach for optimizing outcomes. It also touches on topics like biologic therapy, clinical trial outcomes comparing different treatment modalities, and the role of surgery in CLTI. The review aims to provide endovascular operators with a detailed guide for navigating the complexities of BTK revascularization to enhance patient outcomes and salvage limbs effectively.

Keywords

endovascular revascularization

chronic limb-threatening ischemia

patient selection

Below-the-Knee revascularization

complications

wire selection strategies

balloon angioplasty

surgical interventions

multidisciplinary approach

limb salvage