Vascular Solutions

Subintimal Angioplasty: Overview and case selection

Lower extemity disease diagnosis and traditional bypass surgical treatments are covered in more detail within this web site. With recent advances in endovascular procedures, a variety of new percutaneous or minimally invasive procedures have been developed and tried in an attempt to improve blood flow to lower extremities in patients who many be at risk using traditional methods. Subintimal angioplasty is such a procedure that provides a means to open a totally occluded blood vessel. This procedure was first performed and reported by doctors in Leicester, UK. Until recently, the subintimal angioplasty methods for treatment were not frequently performed in the United States. This techniques requires that a wire pass within the wall of a blood vessel but not within the occluded "true" lumen of the vessel. One a wire has been passed into the natural, true lumen of the blood vessel, below the occlusion, a balloon is used to open this new pathway. Thus a wide open smooth passage is available for blood to pass freely into the calf and foot. The results short and intermediate terms has been very good. Long term data is still not available. Certainly the risks of the procedure and complication rate is much less than bypass surgery. Limb salvage and resolution of claudication symptoms has been remarkably good in the hands of Vascular Solutions doctors. Examples of some cases utilizing these techniques are available for review at the links listed below:

Popliteal Occlusion with rest pain

SFA and Pop Occlusion with gangrene of the foot

Ischemia with SFA occlusion

Ischemia of Foot following thrombosed distal bypass

Rest Pain with impending tissue loss

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