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Review
. 2024 Mar 11;17(5):589-607.
doi: 10.1016/j.jcin.2023.11.040. Epub 2024 Jan 17.

Below-the-Knee Endovascular Revascularization: A Position Statement

Jun Li  1 , Ramon Varcoe  2 , Marco Manzi  3 , Steven Kum  4 , Osamu Iida  5 , Andrej Schmidt  6 , Mehdi H Shishehbor  7
Affiliations
Free article
Review

Below-the-Knee Endovascular Revascularization: A Position Statement

Jun Li et al. JACC Cardiovasc Interv. .
Free article

Abstract

Patients with chronic limb-threatening ischemia, the terminal stage of peripheral artery disease, are frequently afflicted by below-the-knee disease. Although all patients should receive guideline-directed medical therapy, restoration of inline flow is oftentimes necessary to avoid limb loss. Proper patient selection and proficiency in endovascular techniques for below-the-knee revascularization are intended to prevent major amputation and promote wound healing. This review, a consensus among an international panel of experienced operators, provides guidance on these challenges from an endovascular perspective and offers techniques to navigate this complex disease process.

Keywords: CLTI; below the knee; chronic limb-threatening ischemia; endovascular revascularization.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Li has served on the advisory board for Boston Scientific, Inari Medical, and Medtronic; and as a consultant for Abbott Vascular, Endovascular Engineering, and Philips. Dr Varcoe has served as a consultant for Abbott Vascular, Intact Medical, Shockwave, Intervene, Surmodics, and Boston Scientific; and on the advisory board for Abbott Vascular and Intact Medical. Dr Manzi has served as a consultant for Abbott Vascular, Bard/BD, Boston Scientific, Angiodroid, Cook, and Terumo. Dr Kum has served as a consultant for Abbott Vascular, Boston Scientific, and LimFlow. Dr Iida has reported that he has no relationships relevant to the contents of this paper to disclose. Dr Schmidt has received consulting and speaker honoraria from Abbott Vascular, Boston Scientific, Bard/BD, Cook, Cordis, Intact Vascular, Medtronic, Reflow, and Upstream Peripheral. Dr Shishehbor has served on the global advisory board for Abbott Vascular, Medtronic, Terumo, Phillips, Boston Scientific, ANT, and Inquis Medical.

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