Bauer E. Sumpio, MD, PhD, Rachael O. Forsythe, MBChB, MRCS, Kenneth R

Slides:

Advertisements

Similar presentations

The angiosome theory to guide revascularization for CLI

Advertisements

Richard F. Neville, MD Professor, Department of Surgery

The angiosome concept; open and endovascular treatment of CLI

The impact of arterial pedal arch quality and angiosome revascularization on foot tissue loss healing and infrapopliteal bypass outcome Hisham Rashid,

‘Real Angiosome’ Assessment from Peripheral Tissue Perfusion Using Tissue Oxygen Saturation Foot-mapping in Patients with Critical Limb Ischemia Y. Kagaya,

Education in vascular surgery: Critical issues in India

Corridor-based functional performance measures correlate better with physical activity during daily life than treadmill measures in persons with peripheral.

Tibiotibial vein bypass grafts: A new operation for limb salvage

The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: Risk stratification based on Wound, Ischemia, and foot Infection.

Gluteopopliteal bypass for a compromised groin

New routing alternative for proximal anterior tibial artery bypass in patients with Buerger disease Taeseung Lee, MD, PhD, Hwan Do Ra, MD, Yang Jin Park,

Low-dose direct fibrinolysis in peripheral vascular disease

Brandon J. Sumpio, BA, Gianluca Citoni, MD, Jason A. Chin, MD, Bauer E

Angiosome-targeted infrapopliteal endovascular revascularization for treatment of diabetic foot ulcers Maria Söderström, MD, PhD, Anders Albäck, MD,

Magnetic resonance angiography in the management of lower extremity arterial occlusive disease: A prospective study Richard P. Cambria, MD, John A. Kaufman,

True lumen re-entry after extravascular recanalization of a superficial femoral artery chronic total occlusion Jason K. Wagner, MS, Rabih A. Chaer, MD,

A percutaneous arterial closure protocol can decrease complications after endovascular interventions in vascular surgery patients Philip P. Goodney,

Regional variation in patient selection and treatment for lower extremity vascular disease in the Vascular Quality Initiative Peter A. Soden, MD, Sara.

Frank Pomposelli, MD Journal of Vascular Surgery

Decision analysis model of open repair versus endovascular treatment in patients with asymptomatic popliteal artery aneurysms Wouter Hogendoorn, MD,

Amir H. Malkawi, MRCS, Robert J

Foot claudication with plantar flexion as a result of dorsalis pedis artery impingement in an Irish dancer Brigitte K. Smith, MD, Travis Engelbert, MD,

Open bypass and endovascular procedures among diabetic foot ulcer cases in the United States from 2001 to 2010 Grant H. Skrepnek, PhD, David G. Armstrong,

Surgical result of critical limb ischemia due to tibial arterial occlusion in patients with systemic scleroderma Juno Deguchi, MD, PhD, Kunihiro Shigematsu,

Evaluation of hyperspectral technology for assessing the presence and severity of peripheral artery disease Jason A. Chin, BSE, Edward C. Wang, PhD,

Marlin Wayne Causey, MD, Morohunranti O

Louis L. Nguyen, MD, MBA, MPH Journal of Vascular Surgery

Long-term safety of cilostazol in patients with peripheral artery disease: The CASTLE study (Cilostazol: A Study in Long-term Effects) William R. Hiatt,

Ambulatory venous pressure revisited

Predictive value of angiographic scores for the integrated management of the ischemic diabetic foot Irene Bargellini, MD, Alberto Piaggesi, MD, Antonio.

Compartment syndrome with foot ischemia after inversion injury of the ankle Blandine Maurel, MD, Jean Brilhault, MD, Robert Martinez, MD, Patrick Lermusiaux,

SPY technology as an adjunctive measure for lower extremity perfusion

The potential for lower extermity revascularization without contrast arteriography: Experience with magnetic resonance angiography Richard P. Cambria,

Use of magnetic resonance angiography for the preoperative evaluation of patients with infrainguinal arterial occlusive disease John R. Hoch, MD, Michael.

Endovascular native vessel recanalization to maintain limb perfusion after infected prosthetic vascular graft excision Victor Z. Erzurum, MD, Dan Clair,

Percutaneous transluminal angioplasty for the treatment of limb threatening ischemia: Do the results justify an attempt before bypass grafting? Richard.

Education in vascular surgery: Critical issues in India

Characterization of tibial velocities by duplex ultrasound in severe peripheral arterial disease and controls Jeffrey D. Crawford, MD, Nicholas G. Robbins,

Long-term results of direct and indirect endovascular revascularization based on the angiosome concept in patients with critical limb ischemia presenting.

Regarding “Endovascular treatment of atherosclerotic popliteal artery disease based on dynamic angiography findings” Jose Antonio Diaz, MD Journal of.

Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial: A description of the severity and extent of disease using the Bollinger angiogram.

Regarding “The anatomy of the small saphenous vein: Fascial and neural relations, saphenofemoral junction, and valves” Alberto Caggiati, MD Journal.

Dorsalis pedis arterial bypass: Durable limb salvage for foot ischemia in patients with diabetes mellitus Frank B. Pomposelli, MD, Edward J. Marcaccio,

Retrograde popliteal approach for challenging occlusions of the femoral-popliteal arteries Meng Ye, PhD, MD, Hao Zhang, MD, PhD, Xiaozhong Huang, MD,

Clinical effects of single or double tibial artery revascularization in critical limb ischemia patients with tissue loss Norihiro Kobayashi, MD, Keisuke.

The BASIL survival prediction model in patients with peripheral arterial disease undergoing revascularization in a university hospital setting and comparison.

New routing alternative for proximal anterior tibial artery bypass in patients with Buerger disease Taeseung Lee, MD, PhD, Hwan Do Ra, MD, Yang Jin Park,

Paul S. van Bemmelen, MD, PhD, Daniel Spivack, MD, Patrick Kelly, RVT

Intermittent Foot Claudication With Plantar Flexion as a Result of Dorsalis Pedis Artery Impingement in an Irish Dancer Brigitte Smith, MD, Travis Engelbert,

Immediate changes of angiosome perfusion during tibial angioplasty

Early quantitative evaluation of indocyanine green angiography in patients with critical limb ischemia Jonathan D. Braun, MD, Magdiel Trinidad-Hernandez,

Magnetic resonance angiography in the management of lower extremity arterial occlusive disease: A prospective study Richard P. Cambria, MD, John A. Kaufman,

Todd R. Vogel, MD, MPH, Robin L. Kruse, PhD

Persistent sciatic artery presenting with limb ischemia

Ruptured mycotic infrapopliteal aneurysm

Lower extremity bypass vs endovascular therapy for young patients with symptomatic peripheral arterial disease Mauri J.A. Lepäntalo, MD, Rabih Houbballah,

The consequences of an outbreak of multidrug-resistant Pseudomonas aeruginosa among patients treated for critical leg ischemia Maria Söderström, MD,

Regarding “Incidence and clinical significance of peripheral embolization during percutaneous interventions involving the superficial femoral artery”

Incidence and clinical significance of distal embolization during percutaneous interventions involving the superficial femoral artery Russell C. Lam,

Clinical failure after percutaneous transluminal angioplasty of the superficial femoral and popliteal arteries Laura A. Karch, MD, Mark A. Mattos, MD,

Low-dose direct fibrinolysis in peripheral vascular disease

Bradford M. Blakeman, M. D. , Fred N. Littooy, M. D. , William H

Ambulatory venous pressure revisited

Steven P. Rivers, MD, Larry Scher, MD, Frank J. Veith, MD

Rheolytic thrombectomy, angioplasty, and selective stenting for subacute isolated popliteal artery occlusions Hasan H. Dosluoglu, MD, Gregory S. Cherr,

Consequences of hypogastric artery ligation, embolization, or coverage

Peripheral artery and bypass graft thrombolysis with recombinant human tissue-type plasminogen activator Robert A. Graor, M.D., Barbara Risius, M.D.,

The effectiveness of percutaneous transluminal angioplasty for the treatment of critical limb ischemia: A 10-year experience Toshifumi Kudo, MD, PhD,

Corridor-based functional performance measures correlate better with physical activity during daily life than treadmill measures in persons with peripheral.

Thigh claudication due to profunda femoris artery occlusion

Presentation transcript:

Clinical implications of the angiosome model in peripheral vascular disease Bauer E. Sumpio, MD, PhD, Rachael O. Forsythe, MBChB, MRCS, Kenneth R. Ziegler, MD, Jeff G. van Baal, MD, PhD, Mauri J.A. Lepantalo, MD, PhD, Robert J. Hinchliffe, MD, FRCS Journal of Vascular Surgery Volume 58, Issue 3, Pages 814-826 (September 2013) DOI: 10.1016/j.jvs.2013.06.056 Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 1 The foot and ankle area are divided into six angiosomes, with one angiosome fed by the anterior tibial artery (ATA), three by the posterior tibial artery (PTA), and two by the peroneal artery (PA). The ATA gives rise to the dorsalis pedis artery, supplying the anterior compartment and dorsum of the foot (pink). The PTA gives rise to the calcaneal branch, supplying the medial ankle (black) and plantar heel (green); the medial plantar branch, supplying the medial instep (yellow); and the lateral plantar branch, supplying the lateral and plantar forefoot (blue). The PA supplies the lateral ankle and plantar heel (red and green overlap) via the lateral calcaneal artery, and the anterior ankle via its anterior perforator (pink overlap). Note the overlap of the heel by both the medial calcaneal branch of the PTA and the lateral calcaneal branch of the PA. Journal of Vascular Surgery 2013 58, 814-826DOI: (10.1016/j.jvs.2013.06.056) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 2 Summary of the article selection process. Journal of Vascular Surgery 2013 58, 814-826DOI: (10.1016/j.jvs.2013.06.056) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 3 Quantitative assessment of local perfusion using indocyanine green (ICG) fluorescence imaging (Photodynamic Eye, Hamamatsu, Japan). Measurements are made from the video sequence with maximum intensity: A, Measurements 1 day before and 1 day after bypass from femoral to distal anterior tibial artery and amputation of 4th and 5th toes. B, Measurements 1 day before and 1 day after multilevel PTA on superficial femoral and popliteal artery as well on tibioperonel trunk and peroneal artery. PTA, Percutaneous transluminal angioplasty; PDE10, fluorescence intensity at 10 seconds from the rising point of the intensity curve, measurements from selected spots of interest (with tcpO2 measurements as reference); T½, time to reach the half of the maximum fluorescence intensity. Journal of Vascular Surgery 2013 58, 814-826DOI: (10.1016/j.jvs.2013.06.056) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 4 Assessment of plantar angiosome perfusion utilizing hyperspectral imaging. The visual, integrated oxyhemoglobin-deoxyhemoglobin, and only deoxyhemoglobin hyperspectral images are shown of the plantar metatarsal angiosome for a foot with no PAD (left) and a foot with PAD (right). The foot with PAD demonstrates substantially decreased oxyhemoglobin and deoxyhemoglobin values throughout the angiosome. (Images courtesy of Jason Chin and Melina Kibbe.) PAD, Peripheral arterial disease. Journal of Vascular Surgery 2013 58, 814-826DOI: (10.1016/j.jvs.2013.06.056) Copyright © 2013 Society for Vascular Surgery Terms and Conditions