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. 2019 Sep 25;12(3):315-318.
doi: 10.3400/avd.ra.19-00042.

Is Angiosome-Guided Endovascular Therapy Worthwhile?

Yosuke Hata  1 , Osamu Iida  1 , Toshiaki Mano  1
Affiliations

Is Angiosome-Guided Endovascular Therapy Worthwhile?

Yosuke Hata et al. Ann Vasc Dis. .

Abstract

Endovascular therapy (EVT) plays a major role in the treatment of critical limb ischemia (CLI). The latest guidelines state that the angiosome concept should be considered when performing revascularization of infrapopliteal lesions in patients with CLI. There have been several reports both of favorable and unfavorable results of angiosome-guided EVT. Based on previous reports, angiosome-guided EVT tends to improve wound healing (WH) rather than amputation-free survival and overall survival. In addition, indirect revascularization based on the angiosome concept with a good collateral flow may achieve good WH comparable to that achieved by direct revascularization. In the future, rather than just debating the effectiveness/ineffectiveness of the angiosome concept, it will be desirable to investigate the patient and lesion characteristics that may have significant influences on WH after angiosome-guided EVT and to apply the results to clinical practice.

Keywords: angiosome concept; critical limb ischemia; endovascular therapy; wound care.

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Conflict of interest statement

Disclosure StatementNone.

References

    1. Aboyans V, Ricco JB, Bartelink MEL, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2018; 55: 305-68. - PubMed
    1. Alexandrescu VA, Hubermont G, Philips Y, et al. Selective primary angioplasty following an angiosome model of reperfusion in the treatment of Wagner 1-4 diabetic foot lesions: practice in a multidisciplinary diabetic limb service. J Endovasc Ther 2008; 15: 580-93. - PubMed
    1. Iida O, Soga Y, Hirano K, et al. Long-term results of direct and indirect endovascular revascularization based on the angiosome concept in patients with critical limb ischemia presenting with isolated below-the-knee lesions. J Vasc Surg 2012; 55: 363-70.e5. - PubMed
    1. Söderström M, Albäck A, Biancari F, et al. Angiosome-targeted infrapopliteal endovascular revascularization for treatment of diabetic foot ulcers. J Vasc Surg 2013; 57: 427-35. - PubMed
    1. Shiraki T, Iida O, Takahara M, et al. Predictors of delayed wound healing after endovascular therapy of isolated infrapopliteal lesions underlying critical limb ischemia in patients with high prevalence of diabetes mellitus and hemodialysis. Eur J Vasc Endovasc Surg 2015; 49: 565-73. - PubMed