Knee Extension Knee Flexion Problems with SFA Stenting….
With Knee Flexion
Compression 3. Extension / Contraction 1. Torsion 2. Flexion4. Forces Exerted on Stents in SFA
Type I Type II Type III Type IV
After Before Directional Atherectomy
Conclusions Peripheral Vascular Disease is very prevalent in patients with cardiac disease PVD is underdiagnosed and undertreated High Mortality with PVD – usually due to cardiac causes There are many revascularization options available to patients to improve quality of life
PercutaneousSurgical Patient Preference
Treating Critical Limb Ischemia Primary Treatment for severe PVD in the 1800’s
Treating Critical Limb Ischemia In some places Primary Treatment for severe PVD in 2008
Amputations – current data Less than 20% get an angiogram Only 50% get an ABI Most of these patients do have limb salvage options It is not conservative treatment to amputate!
“For some reason, it is considered conservative treatment to chop someone’s leg off and aggressive treatment to even do an angiogram”
Amputation (Impact!!) Survivors who ambulate (prosthesis) BKA % AKA - 25% Psychological testing :“worse than cancer”