ENDOVASCULAR TREATMENT OF CALCIFIED FEMOROPOPLITEAL LESIONS
DOI:
https://doi.org/10.48750/acv.69Keywords:
P eripheral arterial disease, endovascular treatment, calcificationAbstract
Vascular calcification is a frequent finding in peripheral arterial disease and remains an additional challenge to endovascular treatment in both recanalization and durability of interventions. The lack of standardization in the classification of peripheral artery calcification has led to a defective characterization of the performance of endovascular devices in the subgroup of calcified lesions of the femoropopliteal sector. The objective of this review is to make a survey of the available evidence regarding the current options in the endovascular treatment of highly calcified lesions of the femoropopliteal sector.
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References
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Outback catheter for femoropopliteal occlusions: immediate and
long-term results. J Endovasc Ther. 2011;18:13-21.
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G. Excimer laser-assisted recanalization of long, chronic superficial
femoral artery occlusions. J Endovasc Ther. 2001;8:156-66.
3. Scheinert D, Braunlich S, Scheinert S, Ulrich M, Biamino G, Schmidt
A. Initial clinical experience with an IVUS-guided transmembrane
puncture device to facilitate recanalization of total femoral
artery occlusions. EuroIntervention. 2005;1:115-9.
4. Okuno S, Iida O, Shiraki T, Fujita M, Masuda M, Okamoto S, et al.
Impact of Calcification on Clinical Outcomes After Endovascular
Therapy for Superficial Femoral Artery Disease: Assessment
Using the Peripheral Artery Calcification Scoring System. J Endovasc
Ther. 2016;23:731-7.
5. Patel SD, Zymvragoudakis V, Sheehan L, Lea T, Modarai B, Katsanos
K, et al. Atherosclerotic Plaque Analysis: A Pilot Study to Assess a
Novel Tool to Predict Outcome Following Lower Limb Endovascular
Intervention. Eur J Vasc Endovasc Surg. 2015;50:487-93.
6. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes
FG, et al. Inter-Society Consensus for the Management of Peripheral
Arterial Disease (TASC II). J Vasc Surg. 2007;45 Suppl S:S5-67.
7. Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K,
et al. The SYNTAX Score: an angiographic tool grading the complexity
of coronary artery disease. EuroIntervention. 2005;1:219-27.
8. Rocha-Singh KJ, Zeller T, Jaff MR. Peripheral arterial calcification:
prevalence, mechanism, detection, and clinical implications.
Catheter Cardiovasc Interv. 2014;83:E212-20.
9. Fanelli F, Cannavale A, Gazzetti M, Lucatelli P, Wlderk A, Cirelli
C, et al. Calcium burden assessment and impact on drug-eluting
balloons in peripheral arterial disease. Cardiovasc Intervent
Radiol. 2014;37:898-907.
10. Capek P, McLean GK, Berkowitz HD. Femoropopliteal angioplasty.
Factors influencing long-term success. Circulation. 1991;83:I70-80.
11. Fanelli F, Cannavale A, Corona M, Lucatelli P, Wlderk A, Salvatori
FM. The "DEBELLUM"--lower limb multilevel treatment with drug
eluting balloon--randomized trial: 1-year results. J Cardiovasc
Surg (Torino). 2014;55:207-16.
12. Fanelli F, Cannavale A, Boatta E, Corona M, Lucatelli P, Wlderk A,
et al. Lower limb multilevel treatment with drug-eluting balloons:
6-month results from the DEBELLUM randomized trial. J Endovasc
Ther. 2012;19:571-80.
13. Tepe G, Beschorner U, Ruether C, Fischer I, Pfaffinger P, Noory E,
et al. Drug-Eluting Balloon Therapy for Femoropopliteal Occlusive
Disease: Predictors of Outcome With a Special Emphasis on
Calcium. J Endovasc Ther. 2015;22:727-33.
14. Rocha-Singh KJ, Beckman JA, Ansel G, Lyden SP, Schneider P,
Mehta M, et al. Patient-level meta-analysis of 999 claudicants
undergoing primary femoropopliteal nitinol stent implantation.
Catheter Cardiovasc Interv. 2017;
15. Acin F, de Haro J, Bleda S, Varela C, Esparza L. Primary nitinol
stenting in femoropopliteal occlusive disease: a meta-analysis
of randomized controlled trials. J Endovasc Ther. 2012;19:585-95.
16. Chan YC, Cheng SW, Cheung GC. Predictors of restenosis in the
use of helical interwoven nitinol stents to treat femoropopliteal
occlusive disease. J Vasc Surg. 2015;62:1201-9.
17. Garcia L, Jaff MR, Metzger C, Sedillo G, Pershad A, Zidar F, et al.
Wire-Interwoven Nitinol Stent Outcome in the Superficial Femoral
and Proximal Popliteal Arteries: Twelve-Month Results of the
SUPERB Trial. Circ Cardiovasc Interv. 2015;8:
18. Myint M, Schouten O, Bourke V, Thomas SD, Lennox AF, Varcoe
RL. A Real-World Experience With the Supera Interwoven Nitinol
Stent in Femoropopliteal Arteries: Midterm Patency Results and
Failure Analysis. J Endovasc Ther. 2016;23:433-41.
19. Scheinert D, Grummt L, Piorkowski M, Sax J, Scheinert S, Ulrich M,
et al. A novel self-expanding interwoven nitinol stent for complex
femoropopliteal lesions: 24-month results of the SUPERA SFA
registry. J Endovasc Ther. 2011;18:745-52.
20. Palena LM, Diaz-Sandoval LJ, Sultato E, Brigato C, Candeo A, Brocco
E, et al. Feasibility and 1-Year outcomes of subintimal revascularization
with supera(R) stenting of long femoropopliteal occlusions
in critical limb ischemia: The "Supersub" Study. Catheter
Cardiovasc Interv. 2016;
21. Werner M, Paetzold A, Banning-Eichenseer U, Scheinert S, Piorkowski
M, Ulrich M, et al. Treatment of complex atherosclerotic
femoropopliteal artery disease with a self-expanding interwoven
nitinol stent: midterm results from the Leipzig SUPERA 500
registry. EuroIntervention. 2014;10:861-8.
22. Duda SH, Bosiers M, Lammer J, Scheinert D, Zeller T, Oliva V, et al.
Drug-eluting and bare nitinol stents for the treatment of atherosclerotic
lesions in the superficial femoral artery: long-term
results from the SIROCCO trial. J Endovasc Ther. 2006;13:701-10.
23. Dake MD, Ansel GM, Jaff MR, Ohki T, Saxon RR, Smouse HB, et al.
Paclitaxel-eluting stents show superiority to balloon angioplasty
and bare metal stents in femoropopliteal disease: twelve-month
Zilver PTX randomized study results. Circ Cardiovasc Interv.
2011;4:495-504.
24. Dake MD, Ansel GM, Jaff MR, Ohki T, Saxon RR, Smouse HB, et al.
Durable Clinical Effectiveness With Paclitaxel-Eluting Stents
in the Femoropopliteal Artery: 5-Year Results of the Zilver PTX
Randomized Trial. Circulation. 2016;133:1472-83; discussion 83.
25. Muller-Hulsbeck S, Keirse K, Zeller T, Schroe H, Diaz-Cartelle J.
Long-Term Results from the MAJESTIC Trial of the Eluvia Paclitaxel-
Eluting Stent for Femoropopliteal Treatment: 3-Year Follow-
-up. Cardiovasc Intervent Radiol. 2017;40:1832-8.
26. Hartung O, Otero A, Dubuc M, Boufi M, Barthelemy P, Aissi K, et
al. Efficacy of Hemobahn in the treatment of superficial femoral
artery lesions in patients with acute or critical ischemia: a
comparative study with claudicants. Eur J Vasc Endovasc Surg.
2005;30:300-6.
27. Mohr PJ, Oyama JK, Luu JT, Stinis CT. Clinical outcomes of endovascular
treatment of TASC-II C and D femoropopliteal lesions
with the Viabahn endoprosthesis. Cardiovasc Revasc Med.
2015;16:465-8.
28. Kruse RR, Poelmann FB, Doomernik D, Burgerhof HG, Fritschy
WM, Moll FL, et al. Five-Year Outcome of Self-Expanding Covered
Stents for Superficial Femoral Artery Occlusive Disease
and an Analysis of Factors Predicting Failure. J Endovasc Ther.
2015;22:855-61.
29. Geraghty PJ, Mewissen MW, Jaff MR, Ansel GM, Investigators V.
Three-year results of the VIBRANT trial of VIABAHN endoprosthesis
versus bare nitinol stent implantation for complex superficial
femoral artery occlusive disease. J Vasc Surg. 2013;58:386-95 e4.
30. Lammer J, Zeller T, Hausegger KA, Schaefer PJ, Gschwendtner M,
Mueller-Huelsbeck S, et al. Sustained benefit at 2 years for covered
stents versus bare-metal stents in long SFA lesions: the VIASTAR
trial. Cardiovasc Intervent Radiol. 2015;38:25-32.
31. Cioppa A, Stabile E, Popusoi G, Salemme L, Cota L, Pucciarelli A,
et al. Combined treatment of heavy calcified femoro-popliteal
lesions using directional atherectomy and a paclitaxel coated
balloon: One-year single centre clinical results. Cardiovasc Revasc
Med. 2012;13:219-23.
32. Roberts D, Niazi K, Miller W, Krishnan P, Gammon R, Schreiber T, et
al. Effective endovascular treatment of calcified femoropopliteal
disease with directional atherectomy and distal embolic protection:
final results of the DEFINITIVE Ca(+)(+) trial. Catheter Cardiovasc
Interv. 2014;84:236-44.
33. Zeller T, Langhoff R, Rocha-Singh KJ, Jaff MR, Blessing E, Amann-
-Vesti B, et al. Directional Atherectomy Followed by a Paclitaxel-
Coated Balloon to Inhibit Restenosis and Maintain Vessel
Patency: Twelve-Month Results of the DEFINITIVE AR Study. Circ
Cardiovasc Interv. 2017;10:
34. Ott I, Cassese S, Groha P, Steppich B, Hadamitzky M, Ibrahim T,
et al. Randomized Comparison of Paclitaxel-Eluting Balloon and
Stenting Versus Plain Balloon Plus Stenting Versus Directional
Atherectomy for Femoral Artery Disease (ISAR-STATH). Circulation.
2017;135:2218-26.
Outback catheter for femoropopliteal occlusions: immediate and
long-term results. J Endovasc Ther. 2011;18:13-21.
2. Scheinert D, Laird JR, Jr., Schroder M, Steinkamp H, Balzer JO, Biamino
G. Excimer laser-assisted recanalization of long, chronic superficial
femoral artery occlusions. J Endovasc Ther. 2001;8:156-66.
3. Scheinert D, Braunlich S, Scheinert S, Ulrich M, Biamino G, Schmidt
A. Initial clinical experience with an IVUS-guided transmembrane
puncture device to facilitate recanalization of total femoral
artery occlusions. EuroIntervention. 2005;1:115-9.
4. Okuno S, Iida O, Shiraki T, Fujita M, Masuda M, Okamoto S, et al.
Impact of Calcification on Clinical Outcomes After Endovascular
Therapy for Superficial Femoral Artery Disease: Assessment
Using the Peripheral Artery Calcification Scoring System. J Endovasc
Ther. 2016;23:731-7.
5. Patel SD, Zymvragoudakis V, Sheehan L, Lea T, Modarai B, Katsanos
K, et al. Atherosclerotic Plaque Analysis: A Pilot Study to Assess a
Novel Tool to Predict Outcome Following Lower Limb Endovascular
Intervention. Eur J Vasc Endovasc Surg. 2015;50:487-93.
6. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes
FG, et al. Inter-Society Consensus for the Management of Peripheral
Arterial Disease (TASC II). J Vasc Surg. 2007;45 Suppl S:S5-67.
7. Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K,
et al. The SYNTAX Score: an angiographic tool grading the complexity
of coronary artery disease. EuroIntervention. 2005;1:219-27.
8. Rocha-Singh KJ, Zeller T, Jaff MR. Peripheral arterial calcification:
prevalence, mechanism, detection, and clinical implications.
Catheter Cardiovasc Interv. 2014;83:E212-20.
9. Fanelli F, Cannavale A, Gazzetti M, Lucatelli P, Wlderk A, Cirelli
C, et al. Calcium burden assessment and impact on drug-eluting
balloons in peripheral arterial disease. Cardiovasc Intervent
Radiol. 2014;37:898-907.
10. Capek P, McLean GK, Berkowitz HD. Femoropopliteal angioplasty.
Factors influencing long-term success. Circulation. 1991;83:I70-80.
11. Fanelli F, Cannavale A, Corona M, Lucatelli P, Wlderk A, Salvatori
FM. The "DEBELLUM"--lower limb multilevel treatment with drug
eluting balloon--randomized trial: 1-year results. J Cardiovasc
Surg (Torino). 2014;55:207-16.
12. Fanelli F, Cannavale A, Boatta E, Corona M, Lucatelli P, Wlderk A,
et al. Lower limb multilevel treatment with drug-eluting balloons:
6-month results from the DEBELLUM randomized trial. J Endovasc
Ther. 2012;19:571-80.
13. Tepe G, Beschorner U, Ruether C, Fischer I, Pfaffinger P, Noory E,
et al. Drug-Eluting Balloon Therapy for Femoropopliteal Occlusive
Disease: Predictors of Outcome With a Special Emphasis on
Calcium. J Endovasc Ther. 2015;22:727-33.
14. Rocha-Singh KJ, Beckman JA, Ansel G, Lyden SP, Schneider P,
Mehta M, et al. Patient-level meta-analysis of 999 claudicants
undergoing primary femoropopliteal nitinol stent implantation.
Catheter Cardiovasc Interv. 2017;
15. Acin F, de Haro J, Bleda S, Varela C, Esparza L. Primary nitinol
stenting in femoropopliteal occlusive disease: a meta-analysis
of randomized controlled trials. J Endovasc Ther. 2012;19:585-95.
16. Chan YC, Cheng SW, Cheung GC. Predictors of restenosis in the
use of helical interwoven nitinol stents to treat femoropopliteal
occlusive disease. J Vasc Surg. 2015;62:1201-9.
17. Garcia L, Jaff MR, Metzger C, Sedillo G, Pershad A, Zidar F, et al.
Wire-Interwoven Nitinol Stent Outcome in the Superficial Femoral
and Proximal Popliteal Arteries: Twelve-Month Results of the
SUPERB Trial. Circ Cardiovasc Interv. 2015;8:
18. Myint M, Schouten O, Bourke V, Thomas SD, Lennox AF, Varcoe
RL. A Real-World Experience With the Supera Interwoven Nitinol
Stent in Femoropopliteal Arteries: Midterm Patency Results and
Failure Analysis. J Endovasc Ther. 2016;23:433-41.
19. Scheinert D, Grummt L, Piorkowski M, Sax J, Scheinert S, Ulrich M,
et al. A novel self-expanding interwoven nitinol stent for complex
femoropopliteal lesions: 24-month results of the SUPERA SFA
registry. J Endovasc Ther. 2011;18:745-52.
20. Palena LM, Diaz-Sandoval LJ, Sultato E, Brigato C, Candeo A, Brocco
E, et al. Feasibility and 1-Year outcomes of subintimal revascularization
with supera(R) stenting of long femoropopliteal occlusions
in critical limb ischemia: The "Supersub" Study. Catheter
Cardiovasc Interv. 2016;
21. Werner M, Paetzold A, Banning-Eichenseer U, Scheinert S, Piorkowski
M, Ulrich M, et al. Treatment of complex atherosclerotic
femoropopliteal artery disease with a self-expanding interwoven
nitinol stent: midterm results from the Leipzig SUPERA 500
registry. EuroIntervention. 2014;10:861-8.
22. Duda SH, Bosiers M, Lammer J, Scheinert D, Zeller T, Oliva V, et al.
Drug-eluting and bare nitinol stents for the treatment of atherosclerotic
lesions in the superficial femoral artery: long-term
results from the SIROCCO trial. J Endovasc Ther. 2006;13:701-10.
23. Dake MD, Ansel GM, Jaff MR, Ohki T, Saxon RR, Smouse HB, et al.
Paclitaxel-eluting stents show superiority to balloon angioplasty
and bare metal stents in femoropopliteal disease: twelve-month
Zilver PTX randomized study results. Circ Cardiovasc Interv.
2011;4:495-504.
24. Dake MD, Ansel GM, Jaff MR, Ohki T, Saxon RR, Smouse HB, et al.
Durable Clinical Effectiveness With Paclitaxel-Eluting Stents
in the Femoropopliteal Artery: 5-Year Results of the Zilver PTX
Randomized Trial. Circulation. 2016;133:1472-83; discussion 83.
25. Muller-Hulsbeck S, Keirse K, Zeller T, Schroe H, Diaz-Cartelle J.
Long-Term Results from the MAJESTIC Trial of the Eluvia Paclitaxel-
Eluting Stent for Femoropopliteal Treatment: 3-Year Follow-
-up. Cardiovasc Intervent Radiol. 2017;40:1832-8.
26. Hartung O, Otero A, Dubuc M, Boufi M, Barthelemy P, Aissi K, et
al. Efficacy of Hemobahn in the treatment of superficial femoral
artery lesions in patients with acute or critical ischemia: a
comparative study with claudicants. Eur J Vasc Endovasc Surg.
2005;30:300-6.
27. Mohr PJ, Oyama JK, Luu JT, Stinis CT. Clinical outcomes of endovascular
treatment of TASC-II C and D femoropopliteal lesions
with the Viabahn endoprosthesis. Cardiovasc Revasc Med.
2015;16:465-8.
28. Kruse RR, Poelmann FB, Doomernik D, Burgerhof HG, Fritschy
WM, Moll FL, et al. Five-Year Outcome of Self-Expanding Covered
Stents for Superficial Femoral Artery Occlusive Disease
and an Analysis of Factors Predicting Failure. J Endovasc Ther.
2015;22:855-61.
29. Geraghty PJ, Mewissen MW, Jaff MR, Ansel GM, Investigators V.
Three-year results of the VIBRANT trial of VIABAHN endoprosthesis
versus bare nitinol stent implantation for complex superficial
femoral artery occlusive disease. J Vasc Surg. 2013;58:386-95 e4.
30. Lammer J, Zeller T, Hausegger KA, Schaefer PJ, Gschwendtner M,
Mueller-Huelsbeck S, et al. Sustained benefit at 2 years for covered
stents versus bare-metal stents in long SFA lesions: the VIASTAR
trial. Cardiovasc Intervent Radiol. 2015;38:25-32.
31. Cioppa A, Stabile E, Popusoi G, Salemme L, Cota L, Pucciarelli A,
et al. Combined treatment of heavy calcified femoro-popliteal
lesions using directional atherectomy and a paclitaxel coated
balloon: One-year single centre clinical results. Cardiovasc Revasc
Med. 2012;13:219-23.
32. Roberts D, Niazi K, Miller W, Krishnan P, Gammon R, Schreiber T, et
al. Effective endovascular treatment of calcified femoropopliteal
disease with directional atherectomy and distal embolic protection:
final results of the DEFINITIVE Ca(+)(+) trial. Catheter Cardiovasc
Interv. 2014;84:236-44.
33. Zeller T, Langhoff R, Rocha-Singh KJ, Jaff MR, Blessing E, Amann-
-Vesti B, et al. Directional Atherectomy Followed by a Paclitaxel-
Coated Balloon to Inhibit Restenosis and Maintain Vessel
Patency: Twelve-Month Results of the DEFINITIVE AR Study. Circ
Cardiovasc Interv. 2017;10:
34. Ott I, Cassese S, Groha P, Steppich B, Hadamitzky M, Ibrahim T,
et al. Randomized Comparison of Paclitaxel-Eluting Balloon and
Stenting Versus Plain Balloon Plus Stenting Versus Directional
Atherectomy for Femoral Artery Disease (ISAR-STATH). Circulation.
2017;135:2218-26.
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Published
2018-12-02
How to Cite
1.
Dias-Neto M, Ramos JF, Teixeira JF. ENDOVASCULAR TREATMENT OF CALCIFIED FEMOROPOPLITEAL LESIONS. Angiol Cir Vasc [Internet]. 2018 Dec. 2 [cited 2024 Apr. 16];14(1):53-9. Available from: https://acvjournal.com/index.php/acv/article/view/69
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Review Article
