Endovascular treatment of below-the-knee region disease is often challenging because of the involvement of arterial bifurcations. Several cases have been reported on the use of coronary stents for the treatment of these patients, but limited evidence is available on the use of dedicated coronary bifurcation devices. We here report the endovascular treatment of a symptomatic bifurcation lesion in below-the-knee region, using a self-expanding Biolimus A9–eluting stent in combination with a “conventional” coronary drug-eluting stent.
FusaroMCasseseSNdrepepaG. Drug-eluting stents for revascularization of infrapopliteal arteries: updated meta-analysis of randomized trials. JACC Cardiovasc Interv. 2013;6(12):1284–1293.
2.
YangXLuXYeKLiXQinJJiangM. Systematic review and meta-analysis of balloon angioplasty versus primary stenting in the infrapopliteal disease. Vasc Endovascular Surg. 2014;48(1):18–26.
3.
DaviesMGSaadWEPedenEKMohiuddinITNaoumJJLumsdenAB. Impact of runoff on superficial femoral artery endoluminal interventions for rest pain and tissue loss. J Vasc Surg. 2008;48(3):619–625.
4.
LeeJJKatzSG. The number of patent tibial vessels does not influence primary patency after nitinol stenting of the femoral and popliteal arteries. J Vasc Surg. 2012;55(4):994–1000.
WernerMScheinertSBausbackY. Bifurcation stenting after failed angioplasty of infrapopliteal arteries in critical limb ischemia: techniques and short-term follow-up. Catheter Cardiovasc Interv. 2013;82(4):E522–E528.
7.
SilingardiRTasselliSCataldiV. Bifurcated coronary stents for infrapopliteal angioplasty in critical limb ischemia. J Vasc Surg. 2013;57(4):1006–1013.
8.
VassilevDMateevHAlexandrovAStankevMRigatelliGGilRJ. Stenting below-the-knee bifurcations with dedicated bifurcation stent BiOSS Lim—first in man case report. Cardiovasc Revasc Med. 2014;15(3):171–177.
9.
BosiersMHartJPDelooseKVerbistJPeetersP. Endovascular therapy as the primary approach for limb salvage in patients with critical limb ischemia: experience with 443 infrapopliteal procedures. Vascular. 2006;14(2):63–69.
10.
Biondi-ZoccaiGSangiorgiGLotrionteM. Infragenicular stent implantation for below-the-knee atherosclerotic disease: clinical evidence from an international collaborative meta-analysis on 640 patients. J Endovasc Ther. 2009;16(3):251–260.
11.
SpiliopoulosSFragkosGKatsanosKDiamantopoulosAKarnabatidisDSiablisD. Long-term outcomes following primary drug-eluting stenting of infrapopliteal bifurcations. J Endovasc Ther. 2012;19(6):788–796.
12.
StabileESalemmeLFerroneM. Abluminal biodegradable polymer-based Biolimus A9-eluting stent for the treatment of infrapopliteal arteries in critical limb ischemia: long-term follow-up. Int J Cardiol. 2016;202:98–99.
13.
GrubeEBuellesfeldLNeumannFJ. Six-month clinical and angiographic results of a dedicated drug-eluting stent for the treatment of coronary bifurcation narrowings. Am J Cardiol. 2007;99(12):1691–1697.
14.
VerheyeSAgostoniPDuboisCL. 9-month clinical, angiographic, and intravascular ultrasound results of a prospective evaluation of the Axxess self-expanding Biolimus A9-eluting stent in coronary bifurcation lesions: the DIVERGE (Drug-Eluting Stent Intervention for Treating Side Branches Effectively) study. J Am Coll Cardiol. 2009;53(12):1031–1039.
15.
BuysschaertIDuboisCLDensJ. Three-year clinical results of the Axxess Biolimus A9 eluting bifurcation stent system: the DIVERGE study. EuroIntervention. 2013;9(5):573–581.
