Drug-Eluting Stents Are the Default Strategy for Superficial Femoral Artery Intervention Now
| Autor: | Mark W. Burket |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Femoral artery Coronary Artery Disease 030204 cardiovascular system & hematology Knee Joint Coronary artery disease 03 medical and health sciences 0302 clinical medicine Physiology (medical) medicine.artery medicine Animals Humans Femur 030212 general & internal medicine Tibia Sirolimus Vascular disease business.industry Endovascular Procedures Drug-Eluting Stents medicine.disease Popliteal artery Surgery Femoral Artery Radiography Bypass surgery Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation. 133(3) |
| ISSN: | 1524-4539 |
| Popis: | Drug-eluting stents (DES) are the default strategy for superficial femoral artery (SFA) intervention in 2015 because they have been evaluated in a large number of patients over a long follow-up period with outcomes superior to other treatment options. No other therapy can make that claim. Response by Garcia on p 329 The SFA and the contiguous popliteal artery constitute the femoropopliteal (FP) segment, which is among the human body’s most hostile vascular environments. It is extremely long, exposed to external compression, and undergoes marked conformational changes every time the leg is flexed. Because it courses posterior to the knee joint, there is obligatory longitudinal compressive force with knee flexion (Figure 1).1 Magnetic resonance angiography studies demonstrated 13% shortening of the SFA between supine and fetal positions.2 There are 60° of SFA torsion produced by simultaneous knee and hip flexion.2 Given these anatomic and dynamic challenges, it is hardly surprising that treatment strategies for established FP atherosclerosis suffer from marked limitations. Figure 1. A , The femoropopliteal arterial segment (represented by the solid black line) is not coaxial with the femur and tibia. B , With knee flexion this relationship creates an excess of arterial length, partially compensated by vessel tortuosity ( C ). Reproduced from Wensing et al1 with permission from the publisher. Copyright © 1995, John Wiley & Sons Ltd. When a disease process lacks 1 definitive cure, a wide variety of marginally effective solutions frequently surface. Such is the case with FP occlusive disease. The spectrum of treatment options is broad, ranging from exercise therapy3 as the least intrusive option, to bypass surgery as the most intrusive.4 In between these extremes lies a seemingly endless variety of endovascular options. ### Less Is Less Perhaps the most universally available and cheapest treatment strategy for symptomatic lower extremity vascular disease is … |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|