J Cardiovasc Interv.  2023 Oct;2(4):220-231. 10.54912/jci.2023.0010.

Advancements in Endovascular Therapy for Chronic Limb-Threatening Ischemia: A Focus on Below-the-Ankle Interventions and Wound Healing Strategies

• Lee CH
• Lee SW

• KMID: 2560948
• DOI: http://doi.org/10.54912/jci.2023.0010

Abstract

Endovascular therapy (EVT) plays a pivotal role in the management of chronic limbthreatening ischemia (CLTI). The outcomes of limb salvage after EVT in patients with CLTI have improved substantially over the last decade owing to advances in techniques and devices. However, in contrast to these improvements, wound healing rates remain low and represent the major challenging endpoint of clinical trials after below-the-ankle (BTA) interventions. Recently, research on BTA and wound healing has been increasingly carried out, and the concept of EVT has changed from the conventional approach (angiosome concept) to direct wound-related revascularization. This article reviews the basic knowledge and recent concepts of BTA intervention and the pedal-plantar loop technique for complete revascularization.

Keyword

Below-the-ankle; Chronic limb-threatening ischemia; Endovascular therapy; Pedal-plantar loop; Wound healing