The Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC) guidelines were last updated in 2007 (TASC II) and represented the collaboration of international vascular specialties involved in the management of patients with peripheral arterial disease (PAD). Since the publication of TASC II, there have been innovations in endovascular revascularization strategies for patients with PAD. The intent of this publication is to provide a complete anatomic lower limb TASC lesion classification, including the infrapopliteal segment, and an updated literature review of new endovascular techniques and practice patterns employed by vascular specialists today.
DormandyJARutherfordRB. Management of peripheral arterial disease (PAD). TASC Working Group. TransAtlantic Inter-Society Consensus (TASC). J Vasc Surg. 2000;31(1pt 2):S1–S296.
2.
NorgrenLHiattWRDormandyJA. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007;45(suppl S):S5–S67.
3.
KrankenbergHSchluterMSteinkampHJ. Nitinol stent implantation versus percutaneous transluminal angioplasty in superficial femoral artery lesions up to 10 cm in length: the femoral artery stenting trial (FAST). Circulation. 2007;116:285–292.
4.
SaxonRRDakeMDVolgelzangRL. Randomized, multicenter study comparing expanded polytetrafluoroethylene-covered endoprosthesis placement with percutaneous transluminal angioplasty in the treatment of superficial femoral artery occlusive disease. J Vasc Interv Radiol. 2008;19:823–832.
5.
WerkMLangnerSReinkensmeierB. Inhibition of restenosis in femoropopliteal arteries: paclitaxel-coated versus uncoated balloon: femoral paclitaxel randomized pilot trial. Circulation. 2008;118:1358–1365.
6.
GoodneyPPBeckAWNagleJ. National trends in lower extremity bypass surgery, endovascular interventions, and major amputations. J Vasc Surg. 2009;50:54–60.
7.
DiehmNSchillingerMMinarE. TASC II section E3 on the treatment of acute limb ischemia: commentary from European interventionists. J Endovasc Ther. 2008;15:126–128.
8.
SchillingerMDiehmNBaumgartnerI. TASC II section F on revascularization: commentary from an interventionist’s point of view. J Endovasc Ther. 2007;14:734–742.
9.
IndesJEMandawatATuggleCT. Endovascular procedures for aorto-iliac occlusive disease are associated with superior short-term clinical and economic outcomes compared with open surgery in the inpatient population. J Vasc Surg. 2010;52:1173–1179.
10.
IndesJEPfaffMJFarrokhyarF. Clinical outcomes of 5358 patients undergoing direct open bypass or endovascular treatment for aortoiliac occlusive disease: a systematic review and meta-analysis. J Endovasc Ther. 2013;20:443–455.
11.
LevilleCDKashyapVSClairDG. Endovascular management of iliac artery occlusions: extending treatment to TransAtlantic Inter-Society Consensus class C and D patients. J Vasc Surg. 2006;43:32–39.
12.
HansSSDeSantisDSiddiquiR. Results of endovascular therapy and aortobifemoral grafting for Transatlantic Inter-Society type C and D aortoiliac occlusive disease. Surgery. 2008;144:583–590.
13.
JongkindVAkkersdijkGJYeungKK. A systematic review of endovascular treatment of extensive aortoiliac occlusive disease. J Vasc Surg. 2010;52:1376–1383.
14.
YeWLiuCWRiccoJB. Early and late outcomes of percutaneous treatment of TransAtlantic Inter-Society Consensus class C and D aorto-iliac lesions. J Vasc Surg. 2011;53:1728–1737.
15.
ClairDGAdamsJReenB. The EPIC nitinol stent system in the treatment of iliac artery lesions: one-year results from the ORION clinical trial. J Endovasc Ther. 2014;21:213–222.
16.
MwipatayiBPThomasSWongJ. A comparison of covered vs bare expandable stents for the treatment of aortoiliac occlusive disease. J Vasc Surg. 2011;54:1561–1570.
17.
SabriSSChoudhriAOrgeraG. Outcomes of covered kissing stent placement compared with bare metal stent placement in the treatment of atherosclerotic occlusive disease at the aortic bifurcation. J Vasc Interv Radiol. 2010;21:995–1003.
18.
GrimmeFAGoverdePAVan OostayenJA. Covered stents for aortoiliac reconstruction of chronic occlusive lesions. J Cardiovasc Surg (Torino). 2012;53:279–289.
19.
HumphriesMDArmstrongELairdJ. Outcomes of covered versus bare-metal balloon-expandable stents for aortoiliac occlusive disease. J Vasc Surg. 2014;60:337–343.
20.
MurphyTPCutlipDERegensteinerJG. Supervised exercise versus primary stenting for claudication resulting from aortoiliac peripheral artery disease: six-month outcomes from the claudication: exercise versus endoluminal revascularization (CLEVER) study. Circulation. 2012;125:130–139.
21.
MurphyTPCutlipDERegensteinerJG. Supervised exercise, stent revascularization, or medical therapy for claudication due to aortoiliac peripheral artery disease: the CLEVER study. J Am Coll Cardiol. 2015;65:999–1009.
22.
LepantaloMLaurilaKRothWD. PTFE bypass or thrupass for superficial femoral artery occlusion? A randomised controlled trial. Eur J Vasc Endovasc Surg. 2009;37:578–584.
23.
AdamDJBeardJDClevelandT. Bypass versus angioplasty in severe ischaemia of the leg (BASIL): multicentre, randomised controlled trial. Lancet. 2005;366:1925–1934.
24.
BradburyAWAdamDJBellJ. Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial: an intention-to-treat analysis of amputation-free and overall survival in patients randomized to a bypass surgery-first or a balloon angioplasty-first revascularization strategy. J Vasc Surg. 2010;51(5 suppl):5S–17S.
25.
BradburyAWAdamDJBellJ. Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial: analysis of amputation free and overall survival by treatment received. J Vasc Surg. 2010;51(5 suppl):18S–31S.
26.
TepeGZellerTAlbrechtT. Local delivery of paclitaxel to inhibit restenosis during angioplasty of the leg. N Engl J Med. 2008;358:689–699.
27.
FagliaEClericiGAiroldiF. Revascularization by angioplasty of type D femoropopliteal and long infrapopliteal lesion in diabetic patients with critical limb ischemia: are TASC II recommendations suitable? A population-based cohort study. Int J Low Extrem Wounds. 2012;11:277–285.
28.
GargiuloMGiovanettiFBianchini MassoniC. Bypass to the ankle and foot in the era of endovascular therapy of tibial disease. Results and factors influencing the outcome. J Cardiovasc Surg (Torino). 2014;55:367–374.
29.
ConteMSBandykDFClowesAW. Results of PREVENT III: a multicenter, randomized trial of edifoligide for the prevention of vein graft failure in lower extremity bypass surgery. J Vasc Surg. 2006;43:742–751.
30.
LensveltMMHolewijnSFritschyWM. SUrgical versus PERcutaneous Bypass: SUPERB-trial. Heparin-bonded endoluminal versus surgical femoro-popliteal bypass: study protocol for a randomized controlled trial. Trials. 2011;12:178.
31.
JonesWSDolorRJHasselbladV. Comparative effectiveness of endovascular and surgical revascularization for patients with peripheral artery disease and critical limb ischemia: systematic review of revascularization in critical limb ischemia. Am Heart J. 2014;167:489–498.e7.
32.
TwineCPMcLainAD. Graft type for femoro-popliteal bypass surgery. Cochrane Database Syst Rev. 2010;(5):CD001487.
33.
PereiraCEAlbersMRomitiM. Meta-analysis of femoropopliteal bypass grafts for lower extremity arterial insufficiency. J Vasc Surg. 2006;44:510–517.
34.
Norgren LTroeng T. Personal communication on behalf of the Swedish Vascular Registry (SWEDVASC). 2010.
35.
GeraghtyPJMewissenMWJaffMR. Three-year results of the VIBRANT trial of VIABAHN endoprosthesis versus bare nitinol stent implantation for complex superficial femoral artery occlusive disease. J Vasc Surg. 2013;58:386–395.e4.
36.
SaxonRRChervuAJonesPA. Heparin-bonded, expanded polytetrafluoroethylene-lined stent graft in the treatment of femoropopliteal artery disease: 1-year results of the VIPER (Viabahn Endoprosthesis with Heparin Bioactive Surface in the Treatment of Superficial Femoral Artery Obstructive Disease) trial. J Vasc Interv Radiol. 2013;24:165–173.
37.
LairdJRKatzenBTScheinertD. Nitinol stent implantation versus balloon angioplasty for lesions in the superficial femoral artery and proximal popliteal artery: twelve-month results from the RESILIENT randomized trial. Circ Cardiovasc Interv. 2010;3:267–276.
38.
LairdJRKatzenBTScheinertD. Nitinol stent implantation vs. balloon angioplasty for lesions in the superficial femoral and proximal popliteal arteries of patients with claudication: three-year follow-up from the RESILIENT randomized trial. J Endovasc Ther. 2012;19:1–9.
SchillingerMSabetiSLoeweC. Balloon angioplasty versus implantation of nitinol stents in the superficial femoral artery. N Engl J Med. 2006;354:1879–1888.
41.
BresciaAAWickersBMCorreaJC. Stenting of femoropopliteal lesions using interwoven nitinol stents. J Vasc Surg. 2015;61:1472–1478.
42.
DasTMustaphaJIndesJ. Technique optimization of orbital atherectomy in calcified peripheral lesions of the lower extremities: the CONFIRM series, a prospective multicenter registry. Catheter Cardiovasc Interv. 2014;83:115–122.
43.
DaveRMPatlolaRKollmeyerK. Excimer laser recanalization of femoropopliteal lesions and 1-year patency: results of the CELLO registry. J Endovasc Ther. 2009;16:665–675.
44.
KorabathinaRModyKPYuJ. Orbital atherectomy for symptomatic lower extremity disease. Catheter Cardiovasc Interv. 2010;76:326–332.
45.
LairdJRZellerTGrayBH. Limb salvage following laser-assisted angioplasty for critical limb ischemia: results of the LACI multicenter trial. J Endovasc Ther. 2006;13:1–11.
46.
ZellerTKrankenbergHSteinkampH. One-year outcome of percutaneous rotational atherectomy with aspiration in infrainguinal peripheral arterial occlusive disease: the multicenter pathway PVD trial. J Endovasc Ther. 2009;16:653–662.
47.
ZellerTRastanASixtS. Long-term results after directional atherectomy of femoro-popliteal lesions. J Am Coll Cardiol. 2006;48:1573–1578.
48.
McKinseyJFZellerTRocha-SinghKJ. Lower extremity revascularization using directional atherectomy: 12-month prospective results of the DEFINITIVE LE study. JACC Cardiovasc Interv. 2014;7:923–933.
49.
DakeMDAnselGMJaffMR. Sustained safety and effectiveness of paclitaxel-eluting stents for femoropopliteal lesions: 2-year follow-up from the Zilver PTX randomized and single-arm clinical studies. J Am Coll Cardiol. 2013;61:2417–2427.
50.
ScheinertDDudaSZellerT. The LEVANT I (Lutonix paclitaxel-coated balloon for the prevention of femoropopliteal restenosis) trial for femoropopliteal revascularization: first-in-human randomized trial of low-dose drug-coated balloon versus uncoated balloon angioplasty. JACC Cardiovasc Interv. 2014;7:10–19.
51.
TepeGLairdJSchneiderP. Drug-coated balloon versus standard percutaneous transluminal angioplasty for the treatment of superficial femoral and popliteal peripheral artery disease: 12-month results from the IN.PACT SFA randomized trial. Circulation. 2015;131:495–502.
52.
AntoniouGAChalmersNGeorgiadisGS. A meta-analysis of endovascular versus surgical reconstruction of femoropopliteal arterial disease. J Vasc Surg. 2013;57:242–253.
53.
HiattWR. Medical treatment of peripheral arterial disease and claudication. N Engl J Med. 2001;344:1608–1621.
54.
AlbersMRomitiMBrochado-NetoFC. Meta-analysis of alternate autologous vein bypass grafts to infrapopliteal arteries. J Vasc Surg. 2005;42:449–455.
55.
AlbersMRomitiMPereiraCA. Meta-analysis of allograft bypass grafting to infrapopliteal arteries. Eur J Vasc Endovasc Surg. 2004;28:462–472.
56.
DorweilerBNeufangASchmiedtW. Pedal arterial bypass for limb salvage in patients with diabetes mellitus. Eur J Vasc Endovasc Surg. 2002;24:309–313.
57.
KashyapVSAhnSSQuinones-BaldrichWJ. Infrapopliteal-lower extremity revascularization with prosthetic conduit: a 20-year experience. Vasc Endovascular Surg. 2002;36:255–262.
58.
SchanzerAHeveloneNOwensCD. Technical factors affecting autogenous vein graft failure: observations from a large multicenter trial. J Vasc Surg. 2007;46:1180–1190.
59.
ConteMSGeraghtyPJBradburyAW. Suggested objective performance goals and clinical trial design for evaluating catheter-based treatment of critical limb ischemia. J Vasc Surg. 2009;50:1462–1473.e1-3.
60.
IidaONakamuraMYamauchiY. Endovascular treatment for infrainguinal vessels in patients with critical limb ischemia: OLIVE registry, a prospective, multicenter study in Japan with 12-month follow-up. Circ Cardiovasc Interv. 2013;6:68–76.
61.
IyerSSDorrosGZaitounR. Retrograde recanalization of an occluded posterior tibial artery by using a posterior tibial cutdown: two case reports. Cathet Cardiovasc Diagn. 1990;20:251–253.
62.
RomitiMAlbersMBrochado-NetoFC. Meta-analysis of infrapopliteal angioplasty for chronic critical limb ischemia. J Vasc Surg. 2008;47:975–981.
63.
AnselGMSampleNSBottiICJr. Cutting balloon angioplasty of the popliteal and infrapopliteal vessels for symptomatic limb ischemia. Catheter Cardiovasc Interv. 2004;61:1–4.
64.
DasTMcNamaraTGrayB. Cryoplasty therapy for limb salvage in patients with critical limb ischemia. J Endovasc Ther. 2007;14:753–762.
65.
ZellerTRastanASchwarzwalderU. Midterm results after atherectomy-assisted angioplasty of below-knee arteries with use of the Silverhawk device. J Vasc Interv Radiol. 2004;15:1391–1397.
66.
WhiteCJ. Brave new world: value-based purchasing for peripheral vascular stents is coming to a hospital near you. Circulation. 2013;127:2475–2476.
67.
AntoniouGAChalmersNKanesalinghamK. Meta-analysis of outcomes of endovascular treatment of infrapopliteal occlusive disease with drug-eluting stents. J Endovasc Ther. 2013;20:131–144.
68.
BosiersMScheinertDPeetersP. Randomized comparison of everolimus-eluting versus bare-metal stents in patients with critical limb ischemia and infrapopliteal arterial occlusive disease. J Vasc Surg. 2012;55:390–398.
69.
FusaroMCasseseSNdrepepaG. Drug-eluting stents for revascularization of infrapopliteal arteries: updated meta-analysis of randomized trials. JACC Cardiovasc Interv. 2013;6:1284–1293.
70.
KatsanosKSpiliopoulosSDiamantopoulosA. Systematic review of infrapopliteal drug-eluting stents: a meta-analysis of randomized controlled trials. Cardiovasc Intervent Radiol. 2013;36:645–658.
71.
RastanABrechtelKKrankenbergH. Sirolimus-eluting stents for treatment of infrapopliteal arteries reduce clinical event rate compared to bare-metal stents: long-term results from a randomized trial. J Am Coll Cardiol. 2012;60:587–591.
72.
RastanATepeGKrankenbergH. Sirolimus-eluting stents vs. bare-metal stents for treatment of focal lesions in infrapopliteal arteries: a double-blind, multi-centre, randomized clinical trial. Eur Heart J. 2011;32:2274–2281.
73.
ScheinertDKatsanosKZellerT. A prospective randomized multicenter comparison of balloon angioplasty and infrapopliteal stenting with the sirolimus-eluting stent in patients with ischemic peripheral arterial disease: 1-year results from the ACHILLES trial. J Am Coll Cardiol. 2012;60:2290–2295.
74.
YangXLuXYeK. Systematic review and meta-analysis of balloon angioplasty versus primary stenting in the infrapopliteal disease. Vasc Endovascular Surg. 2014;48:18–26.
75.
SiablisDKitrouPMSpiliopoulosS. Paclitaxel-coated balloon angioplasty versus drug-eluting stenting for the treatment of infrapopliteal long-segment arterial occlusive disease: the IDEAS randomized controlled trial. JACC Cardiovasc Interv. 2014;7:1048–1056.
76.
RandTLammerJRabbiaC. Percutaneous transluminal angioplasty versus turbostatic carbon-coated stents in infrapopliteal arteries: InPeria II trial. Radiology. 2011;261:634–642.
77.
RandonCJacobsBDe RyckF. Angioplasty or primary stenting for infrapopliteal lesions: results of a prospective randomized trial. Cardiovasc Intervent Radiol. 2010;33:260–269.
78.
FeiringAJKrahnMNelsonL. Preventing leg amputations in critical limb ischemia with below-the-knee drug-eluting stents: the PaRADISE (PReventing Amputations using Drug eluting StEnts) trial. J Am Coll Cardiol. 2010;55:1580–1589.
79.
SiablisDKarnabatidisDKatsanosK. Infrapopliteal application of sirolimus-eluting versus bare metal stents for critical limb ischemia: analysis of long-term angiographic and clinical outcome. J Vasc Interv Radiol. 2009;20:1141–1150.
80.
SchmidtAPiorkowskiMWernerM. First experience with drug-eluting balloons in infrapopliteal arteries: restenosis rate and clinical outcome. J Am Coll Cardiol. 2011;58:1105–1109.
81.
FanelliFCannavaleABoattaE. Lower limb multilevel treatment with drug-eluting balloons: 6-month results from the DEBELLUM randomized trial. J Endovasc Ther. 2012;19:571–580.
82.
FanelliFCannavaleACoronaM. The “DEBELLUM” - lower limb multilevel treatment with drug eluting balloon - randomized trial: 1-year results. J Cardiovasc Surg (Torino). 2014;55:207–216.
83.
LiistroFPortoIAngioliP. Drug-eluting balloon in peripheral intervention for below the knee angioplasty evaluation (DEBATE-BTK): a randomized trial in diabetic patients with critical limb ischemia. Circulation. 2013;128:615–621.
84.
ZellerTBaumgartnerIScheinertD. Drug-eluting balloon versus standard balloon angioplasty for infrapopliteal arterial revascularization in critical limb ischemia: 12-month results from the IN.PACT DEEP randomized trial. J Am Coll Cardiol. 2014;64:1568–1576.
85.
FarberARosenfieldKMenardM. The BEST-CLI trial: a multidisciplinary effort to assess which therapy is best for patients with critical limb ischemia. Tech Vasc Interv Radiol. 2014;17:221–224.
ChangRWGoodneyPPBaekJH. Long-term results of combined common femoral endarterectomy and iliac stenting/stent grafting for occlusive disease. J Vasc Surg. 2008;48:362–367.
88.
TimaranCHStevensSLFreemanMB. Infrainguinal arterial reconstructions in patients with aortoiliac occlusive disease: the influence of iliac stenting. J Vasc Surg. 2001;34:971–978.
89.
CreagerMAGoldstoneJHirshfeldJWJr. ACC/ACP/SCAI/SVMB/SVS clinical competence statement on vascular medicine and catheter-based peripheral vascular interventions: a report of the American College of Cardiology/American Heart Association/American College of Physician Task Force on Clinical Competence (ACC/ACP/SCAI/SVMB/SVS Writing Committee to develop a clinical competence statement on peripheral vascular disease). J Am Coll Cardiol. 2004;44:941–957.
90.
MillsJLSrConteMSArmstrongDG. The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: risk stratification based on wound, ischemia, and foot infection (WIfI). J Vasc Surg. 2014;59:220–234.e1-2.
