Vascular and Endovascular Review

VOLUME 6, 2023

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 7, 2024

Comparative Efficacy of Drug-Eluting Stents vs Bare-Metal Stents in Peripheral Arterial Diseases

Miguel Ramírez
Universidad Politécnica de Valencia, Spain.

Abstract

There is currently no demonstrated patency advantage of a drug-eluting stent (DES) over bare metal stents (BMSs) for the treatment of marginal pathway disease of the femoropopliteal the component. In order to compare the patency of BMSs for the treatment of femoropopliteal artery wounds to the Eluvia DES (Boston Scientific, Marlborough, MA), a polymer-coated paclitaxel-eluting stent, the EMINENT study (Trial Comparing Eluvia Versus Bare Metal Stent in Treatment of Superficial Femoral and/or Proximal Popliteal Artery) was conducted. Blinded participation and outcome evaluation are features of the prospective, randomized trials, controlled, multicenter European study EMINENT. For measuring the research study used smart PLS software and generate result included descriptive statistic, correlation also that smart PLS Algorithm model between them. A decrease in Rutherford classification of ≥1 categories from baseline without repeat target lesion revascularization was considered sustained clinical improvement. Walking capacity and health-related quality of life were assessed. Since important meta-analyses of randomized controlled trials in interventional cardiology suggested that drug-eluting stents might reduce the rates of restenosis and reintervention, the use of active protecting technology in peripheral arterial interventions is one of the next steps in the treatment of arterial occlusive disease complying with coronary artery stenting. Overall result found that direct and significant relation in between Drug eluting stents and bare-metal stents in peripheral arterial diseases. Examining the literature on the current uses of drug-eluting stents in peripheral (lower limb, renal, and supra-aortic) settings, examining the financial ramifications, and offering recommendations for future therapeutic approaches in this area of research are our goals.

Keywords : Efficacy (EE), Drug-Eluting Stents (DES), Bare-Metal Stents (BMS), Peripheral Arterial Disease (PAD).
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.
Mark Yang
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty