Evolution and prospect of endovascular revascularization for diabetic infra-popliteal artery occlusion
10.3760/cma.j.cn115396-20250411-00091
- VernacularTitle:糖尿病膝下动脉闭塞腔内血运重建的演变与展望
- Author:
Lianrui GUO
1
;
Jianming GUO
;
Duan LIU
Author Information
1. 首都医科大学宣武医院血管外科，北京 100053
- Keywords:
Diabetes vascular diseases;
Infrapopliteal artery diseases;
Peripheral arterial disease;
Angioplasty;
Revascularization;
Endovascular treatment
- From:
International Journal of Surgery
2025;52(7):433-439
- CountryChina
- Language:Chinese
-
Abstract:
With the aging of the population and changes in lifestyle in China, the number of patients with diabetic infra-popliteal artery occlusion has been growing. Revascularization is of great significance for improving the limb salvage rate and survival rate of patients. By comparing open surgery and endovascular revascularization techniques, although open surgery can improve lower limb ischemia, it has significant trauma and numerous complications. Endovascular treatment, which includes procedures such as lumen recanalization, lumen preparation, and lumen maintenance, has become the preferred option due to its advantages such as minimal trauma. The lumen recanalization technique has continuously advanced with the helping of new devices and the accumulation of experience. Lumen preparation encompasses various methods such as balloon dilation and debulking techniques to address different lesions. In lumen maintenance, drug-coated balloon (DCB) have a certain effect in inhibiting smooth muscle proliferation and improving long-term patency rates. However, the safety of paclitaxel on DCB remains controversial. Stent implantation is not currently recommended due to the characteristics of the infra-popliteal arteries such as small lumen, long lesions, and severe calcification. At present, revascularization for diabetic infra-popliteal artery occlusion still faces challenges. Research on angiogenesis therapy is expected to bring new breakthroughs, and the future development of this field requires the integration of multiple disciplines. This article reviews the development history of revascularization for diabetic infra-popliteal artery lesions, and expounds the transformation of its treatment concept from early arbitrary recanalization to the precise Angiographsome concept.
