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CLI and kidney insufficiency “an unhappy marriage”

CLI and kidney insufficiency “an unhappy marriage”. Reza Ghotbi Gefäßchirurgische Klinik Klinikum München-Pasing der LMU-München. CLI & NI: Eine besondere Population?. Ivan P. Casserly , Advances in Chronic Kidney Disease Volume 15, Issue 4 2008 384 - 395.

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CLI and kidney insufficiency “an unhappy marriage”

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  1. CLI and kidney insufficiency “an unhappy marriage” Reza Ghotbi Gefäßchirurgische Klinik Klinikum München-Pasing der LMU-München

  2. CLI & NI: Eine besondere Population? Ivan P. Casserly , Advances in Chronic Kidney Disease Volume 15, Issue 4 2008 384 - 395

  3. CLI & NI: Eine besondere Population? FaustoBiancari, Scandinavian Journal of Surgery 101:128-143, 2012

  4. CLI & NI: EinebesondereMorphologie? • Occlusionen in 20-40% • Oft alteVerschlüsse • Rekanalisation;Zeitaufwändig, • Significant höhereKontrast und • Strahlenbelastung • HöhereRestenoseRate

  5. Besonderheit der Revaskularisation; Angiosomen Der Kollateralkreislaufisterheblicheingeschränkt. EinintakterArcusplantarisist die Ausnahme.

  6. Besonderheit der Revaskularisation; Angiosomen Alexanderescou et al J of Endovasculartherapy 2011;18:376

  7. J-Beat II Register n=329 Lida O. Soga Y et al. J Vasc Surg. 2011

  8. Periphere Intervention: Equipment • 4 Low profile Katheter • 3 Drähte • 2 Support Katheter • 1 DEB • ca. 1800 Euro Materialkosten

  9. Periphere Intervention: Equipment Drähte - 0.018 V18 - 0.018 Road Runner - 0.014 Galleo - 0.014 V14 PTA Ballon: - passeo 14 - passeo 18 - savvy - DEB Amphirion Stents: - Astronpulsar 4F - Supera6F

  10. Verschlussrecanalisation LASER Outback, Pioneer Crosser

  11. Periphere Intervention: Verfahren PTA SubintimalAngioplastie Stentangioplastie Cuttingballoon Drug eluting Stent Drug elutedBalloon Bioresorbierbarer Stent Laser Cryoplstie Brachytherapie Atherectomie Endograft

  12. CruraleIntervention im Stadium IV 1/11-6/11

  13. CruraleIntervention im Stadium IV 1/11-6/11 40% 21%

  14. CruraleIntervention im Stadium IV 1/11-6/11

  15. CruraleIntervention im Stadium IV 1/11-6/11, Komplikationen

  16. Zusammenfassung • CruraleAngioplastie ist eine effektive Option zum Beinerhalt • Limitiertes Langzeit-Überleben • Alleinige PTA in den meisten Fällen ausreichend • Hohe Restenoserate klinisch nur selten bedeutend • Die Low-profile Technologie reduziert signifikant die lokalen Komplikationen • Die Passage der komplexen Läsionen bleibt eine Herausforderung

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