PAD AND CLI
Dissections
How dissections impact PAD and CLI
Percutaneous transluminal angioplasty (PTA) is a commonly used endovascular intervention for peripheral artery disease (PAD) and critical limb ischemia (CLI) and can be followed by stents within the same procedure, especially if a dissection occurs. Stents may introduce new complications and limit options for retreatment. To prevent some of these complications, drug-coated balloons (DCBs) have been introduced. POBA (plain balloon angioplasty) and DCB therapies are effective, but dissections are a frequent and known problem associated with both. Why? Because untreated dissections may cause acute occlusion and/or thrombus and can negatively affect long-term outcomes.


For informational purposes only. You should always consult with your doctor when seeking medical advice or considering treatment.
References
- Werk M, Albrecht T, Meyer DR et al. Paclitaxel-coated balloons reduce restenosis after femoro-popliteal angioplasty: evidence from the randomized PACIFIER trial. Circ Cardiovasc Interv. 2012;5(6):831-840.
- Tepe G, Laird J, Schneider P et al. Drug-coated balloon versus standard percutaneous transluminal angioplasty for the treatment of superficial femoral and/or popliteal peripheral artery disease: 12-month results from the IN.PACT SFA randomized trial. Circulation. 2014;114.011004
- Tepe G, Zeller T, Schnorr B et al. High-grade, non-flow-limiting dissections do not negatively impact long-term outcome after paclitaxel-coated balloon angioplasty: an additional analysis from the THUNDER study. J Endovasc Ther 2013;20:792-800.
- Rosenfield K, et al. N Engl J Med. 2015;373:145-153 [Suppl].
- Fujihara M, Takahara M, Sasaki S et al. Angiographic dissection patterns and patency outcomes after balloon angioplasty for superficial femoral artery disease. J Endovasc Ther 2017;1-9.
- 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. 2014 Apr;55(2):207-16.
- Razavi MK, Mustapha JA, Miller LE. Contemporary systematic review and meta-analysis of early outcomes with percutaneous treatment for infrapopliteal atherosclerotic disease. J Vasc Interv Radiol. 2014 Oct;25(10):1489-96.