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Tibio‐pedal arterial minimally invasive retrograde revascularization in patients with advanced peripheral vascular disease: The TAMI technique, original case series
Background A tibial‐pedal access method is needed for patients with advanced peripheral artery disease (PAD) unable to tolerate common femoral artery (CFA) access and intervention due to body habitus or comorbidities. This is the first case series reporting an alternative technique to revascularize...
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| Published in: | Catheterization and cardiovascular interventions 2014-05, Vol.83 (6), p.987-994 |
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| cites | cdi_FETCH-LOGICAL-c2837-1e59b25e1a3696b0ce6aa7c28d4dfd789abeea0340f7437792af57de2112ae4f3 |
| container_end_page | 994 |
| container_issue | 6 |
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| container_title | Catheterization and cardiovascular interventions |
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| creator | Mustapha, J.A. Saab, Fadi McGoff, Theresa Heaney, Carmen Diaz‐Sandoval, Larry Sevensma, Matthew Karenko, Barbara |
| description | Background
A tibial‐pedal access method is needed for patients with advanced peripheral artery disease (PAD) unable to tolerate common femoral artery (CFA) access and intervention due to body habitus or comorbidities. This is the first case series reporting an alternative technique to revascularize such patients. Using ultrasound (US) and the tibio‐pedal arterial minimally invasive retrograde revascularization (TAMI) technique, operators accessed, and revascularized the lower extremity completely via tibial‐pedal arterial access.
Methods
This retrospective, single‐center, case series recorded on 23 patients who underwent TAMI revascularization during a seven‐month period in 2012, demonstrating the feasibility and safety of the TAMI technique. Eighty‐three percent had Rutherford Classification IV–VI. Ultrasound guidance aided all tibial access. Demographics, vascular symptoms, disease characteristics, success, procedure length, time to discharge, immediate and 30‐day complications were collected. Comparison was sought with 201 unmatched patients treated via traditional CFA access over a similar period.
Results
Arterial access was successful in all patients. Thirty‐six lesions were treated. Lesion success (ability to cross lesion and achieve post treatment stenosis |
| doi_str_mv | 10.1002/ccd.25227 |
| format | article |
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A tibial‐pedal access method is needed for patients with advanced peripheral artery disease (PAD) unable to tolerate common femoral artery (CFA) access and intervention due to body habitus or comorbidities. This is the first case series reporting an alternative technique to revascularize such patients. Using ultrasound (US) and the tibio‐pedal arterial minimally invasive retrograde revascularization (TAMI) technique, operators accessed, and revascularized the lower extremity completely via tibial‐pedal arterial access.
Methods
This retrospective, single‐center, case series recorded on 23 patients who underwent TAMI revascularization during a seven‐month period in 2012, demonstrating the feasibility and safety of the TAMI technique. Eighty‐three percent had Rutherford Classification IV–VI. Ultrasound guidance aided all tibial access. Demographics, vascular symptoms, disease characteristics, success, procedure length, time to discharge, immediate and 30‐day complications were collected. Comparison was sought with 201 unmatched patients treated via traditional CFA access over a similar period.
Results
Arterial access was successful in all patients. Thirty‐six lesions were treated. Lesion success (ability to cross lesion and achieve post treatment stenosis <30%) was achieved in 95% of patients. 25% of lesions were above the knee. Average prestenosis was 92.5%; average poststenosis 12%. No major complications were noted. Two patients presented within 30 days with access site pain. Access site peroneal artery pseudo‐aneurysms were diagnosed and treated percutaneously with covered stents. Both recovered with no sequelae.
Conclusion
Retrograde tibio‐pedal intervention appears to be safe and effective. The TAMI technique offers an alternate revascularization method for critically ill advanced PAD patients. © 2013 Wiley Periodicals, Inc.</description><identifier>ISSN: 1522-1946</identifier><identifier>EISSN: 1522-726X</identifier><identifier>DOI: 10.1002/ccd.25227</identifier><identifier>PMID: 24214522</identifier><identifier>CODEN: CARIF2</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Aged ; Constriction, Pathologic ; Critical Illness ; critical limb ischemia ; endovascular ; Endovascular Procedures - adverse effects ; Endovascular Procedures - methods ; Feasibility Studies ; Female ; Humans ; Ischemia - diagnosis ; Ischemia - physiopathology ; Ischemia - therapy ; Male ; Michigan ; Patient Positioning ; Patient Selection ; Peripheral Vascular Diseases - diagnosis ; Peripheral Vascular Diseases - physiopathology ; Peripheral Vascular Diseases - therapy ; Radiography ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; tibial access ; Tibial Arteries - diagnostic imaging ; Tibial Arteries - physiopathology ; Time Factors ; Treatment Outcome ; Ultrasonography, Interventional ; ultrasound ; Vascular Patency</subject><ispartof>Catheterization and cardiovascular interventions, 2014-05, Vol.83 (6), p.987-994</ispartof><rights>Copyright © 2013 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2837-1e59b25e1a3696b0ce6aa7c28d4dfd789abeea0340f7437792af57de2112ae4f3</citedby><cites>FETCH-LOGICAL-c2837-1e59b25e1a3696b0ce6aa7c28d4dfd789abeea0340f7437792af57de2112ae4f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24214522$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mustapha, J.A.</creatorcontrib><creatorcontrib>Saab, Fadi</creatorcontrib><creatorcontrib>McGoff, Theresa</creatorcontrib><creatorcontrib>Heaney, Carmen</creatorcontrib><creatorcontrib>Diaz‐Sandoval, Larry</creatorcontrib><creatorcontrib>Sevensma, Matthew</creatorcontrib><creatorcontrib>Karenko, Barbara</creatorcontrib><title>Tibio‐pedal arterial minimally invasive retrograde revascularization in patients with advanced peripheral vascular disease: The TAMI technique, original case series</title><title>Catheterization and cardiovascular interventions</title><addtitle>Catheter Cardiovasc Interv</addtitle><description>Background
A tibial‐pedal access method is needed for patients with advanced peripheral artery disease (PAD) unable to tolerate common femoral artery (CFA) access and intervention due to body habitus or comorbidities. This is the first case series reporting an alternative technique to revascularize such patients. Using ultrasound (US) and the tibio‐pedal arterial minimally invasive retrograde revascularization (TAMI) technique, operators accessed, and revascularized the lower extremity completely via tibial‐pedal arterial access.
Methods
This retrospective, single‐center, case series recorded on 23 patients who underwent TAMI revascularization during a seven‐month period in 2012, demonstrating the feasibility and safety of the TAMI technique. Eighty‐three percent had Rutherford Classification IV–VI. Ultrasound guidance aided all tibial access. Demographics, vascular symptoms, disease characteristics, success, procedure length, time to discharge, immediate and 30‐day complications were collected. Comparison was sought with 201 unmatched patients treated via traditional CFA access over a similar period.
Results
Arterial access was successful in all patients. Thirty‐six lesions were treated. Lesion success (ability to cross lesion and achieve post treatment stenosis <30%) was achieved in 95% of patients. 25% of lesions were above the knee. Average prestenosis was 92.5%; average poststenosis 12%. No major complications were noted. Two patients presented within 30 days with access site pain. Access site peroneal artery pseudo‐aneurysms were diagnosed and treated percutaneously with covered stents. Both recovered with no sequelae.
Conclusion
Retrograde tibio‐pedal intervention appears to be safe and effective. The TAMI technique offers an alternate revascularization method for critically ill advanced PAD patients. © 2013 Wiley Periodicals, Inc.</description><subject>Aged</subject><subject>Constriction, Pathologic</subject><subject>Critical Illness</subject><subject>critical limb ischemia</subject><subject>endovascular</subject><subject>Endovascular Procedures - adverse effects</subject><subject>Endovascular Procedures - methods</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Ischemia - diagnosis</subject><subject>Ischemia - physiopathology</subject><subject>Ischemia - therapy</subject><subject>Male</subject><subject>Michigan</subject><subject>Patient Positioning</subject><subject>Patient Selection</subject><subject>Peripheral Vascular Diseases - diagnosis</subject><subject>Peripheral Vascular Diseases - physiopathology</subject><subject>Peripheral Vascular Diseases - therapy</subject><subject>Radiography</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>tibial access</subject><subject>Tibial Arteries - diagnostic imaging</subject><subject>Tibial Arteries - physiopathology</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Ultrasonography, Interventional</subject><subject>ultrasound</subject><subject>Vascular Patency</subject><issn>1522-1946</issn><issn>1522-726X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNp1kUtOHDEQhi2UiPeCCyBLbIiUAdv98JgdmryQQGwGiV2r2q5mjHq6G7t70LDiCDlFDpaTpGAGFkhZ1a-qr36V6mfsQIoTKYQ6tdadqEwpvcG2JdWRVvntp7WWJs232E6M90IIkyuzybZUqmRKw232Z-pL3_59_t2hg5pD6DF4EnPf-DnU9ZL7ZgHRL5AH7EN7F8C9SOrZoYbgn6D3bUMU70hh00f-6PsZB7eAxqLjHRl2Mwxk-rbEnY8IEc_4dIZ8en51wXu0s8Y_DPiVt8Hf-YZwSwiPtI5xj32uoI64v6677ObH9-nk1-jy-ufF5PxyZNU40SOJmSlVhhKS3OSlsJgDaJq51FVOjw2UiCCSVFQ6TbQ2CqpMO1RSKsC0SnbZ8cq3Cy0dE_ti7qPFuoYG2yEWMpPjXMnMSEKPPqD37RDo7ldKGznOREbUlxVlQxtjwKroAj02LAspipfwCgqveA2P2MO141DO0b2Tb2kRcLoCHn2Ny_87FZPJt5XlP3_vp9g</recordid><startdate>20140501</startdate><enddate>20140501</enddate><creator>Mustapha, J.A.</creator><creator>Saab, Fadi</creator><creator>McGoff, Theresa</creator><creator>Heaney, Carmen</creator><creator>Diaz‐Sandoval, Larry</creator><creator>Sevensma, Matthew</creator><creator>Karenko, Barbara</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20140501</creationdate><title>Tibio‐pedal arterial minimally invasive retrograde revascularization in patients with advanced peripheral vascular disease: The TAMI technique, original case series</title><author>Mustapha, J.A. ; Saab, Fadi ; McGoff, Theresa ; Heaney, Carmen ; Diaz‐Sandoval, Larry ; Sevensma, Matthew ; Karenko, Barbara</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2837-1e59b25e1a3696b0ce6aa7c28d4dfd789abeea0340f7437792af57de2112ae4f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Constriction, Pathologic</topic><topic>Critical Illness</topic><topic>critical limb ischemia</topic><topic>endovascular</topic><topic>Endovascular Procedures - adverse effects</topic><topic>Endovascular Procedures - methods</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Ischemia - diagnosis</topic><topic>Ischemia - physiopathology</topic><topic>Ischemia - therapy</topic><topic>Male</topic><topic>Michigan</topic><topic>Patient Positioning</topic><topic>Patient Selection</topic><topic>Peripheral Vascular Diseases - diagnosis</topic><topic>Peripheral Vascular Diseases - physiopathology</topic><topic>Peripheral Vascular Diseases - therapy</topic><topic>Radiography</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>tibial access</topic><topic>Tibial Arteries - diagnostic imaging</topic><topic>Tibial Arteries - physiopathology</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Ultrasonography, Interventional</topic><topic>ultrasound</topic><topic>Vascular Patency</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mustapha, J.A.</creatorcontrib><creatorcontrib>Saab, Fadi</creatorcontrib><creatorcontrib>McGoff, Theresa</creatorcontrib><creatorcontrib>Heaney, Carmen</creatorcontrib><creatorcontrib>Diaz‐Sandoval, Larry</creatorcontrib><creatorcontrib>Sevensma, Matthew</creatorcontrib><creatorcontrib>Karenko, Barbara</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Catheterization and cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mustapha, J.A.</au><au>Saab, Fadi</au><au>McGoff, Theresa</au><au>Heaney, Carmen</au><au>Diaz‐Sandoval, Larry</au><au>Sevensma, Matthew</au><au>Karenko, Barbara</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tibio‐pedal arterial minimally invasive retrograde revascularization in patients with advanced peripheral vascular disease: The TAMI technique, original case series</atitle><jtitle>Catheterization and cardiovascular interventions</jtitle><addtitle>Catheter Cardiovasc Interv</addtitle><date>2014-05-01</date><risdate>2014</risdate><volume>83</volume><issue>6</issue><spage>987</spage><epage>994</epage><pages>987-994</pages><issn>1522-1946</issn><eissn>1522-726X</eissn><coden>CARIF2</coden><abstract>Background
A tibial‐pedal access method is needed for patients with advanced peripheral artery disease (PAD) unable to tolerate common femoral artery (CFA) access and intervention due to body habitus or comorbidities. This is the first case series reporting an alternative technique to revascularize such patients. Using ultrasound (US) and the tibio‐pedal arterial minimally invasive retrograde revascularization (TAMI) technique, operators accessed, and revascularized the lower extremity completely via tibial‐pedal arterial access.
Methods
This retrospective, single‐center, case series recorded on 23 patients who underwent TAMI revascularization during a seven‐month period in 2012, demonstrating the feasibility and safety of the TAMI technique. Eighty‐three percent had Rutherford Classification IV–VI. Ultrasound guidance aided all tibial access. Demographics, vascular symptoms, disease characteristics, success, procedure length, time to discharge, immediate and 30‐day complications were collected. Comparison was sought with 201 unmatched patients treated via traditional CFA access over a similar period.
Results
Arterial access was successful in all patients. Thirty‐six lesions were treated. Lesion success (ability to cross lesion and achieve post treatment stenosis <30%) was achieved in 95% of patients. 25% of lesions were above the knee. Average prestenosis was 92.5%; average poststenosis 12%. No major complications were noted. Two patients presented within 30 days with access site pain. Access site peroneal artery pseudo‐aneurysms were diagnosed and treated percutaneously with covered stents. Both recovered with no sequelae.
Conclusion
Retrograde tibio‐pedal intervention appears to be safe and effective. The TAMI technique offers an alternate revascularization method for critically ill advanced PAD patients. © 2013 Wiley Periodicals, Inc.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>24214522</pmid><doi>10.1002/ccd.25227</doi><tpages>8</tpages></addata></record> |
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| ispartof | Catheterization and cardiovascular interventions, 2014-05, Vol.83 (6), p.987-994 |
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| source | Wiley |
| subjects | Aged Constriction, Pathologic Critical Illness critical limb ischemia endovascular Endovascular Procedures - adverse effects Endovascular Procedures - methods Feasibility Studies Female Humans Ischemia - diagnosis Ischemia - physiopathology Ischemia - therapy Male Michigan Patient Positioning Patient Selection Peripheral Vascular Diseases - diagnosis Peripheral Vascular Diseases - physiopathology Peripheral Vascular Diseases - therapy Radiography Retrospective Studies Risk Factors Severity of Illness Index tibial access Tibial Arteries - diagnostic imaging Tibial Arteries - physiopathology Time Factors Treatment Outcome Ultrasonography, Interventional ultrasound Vascular Patency |
| title | Tibio‐pedal arterial minimally invasive retrograde revascularization in patients with advanced peripheral vascular disease: The TAMI technique, original case series |
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