Medicina (Kaunas) 2009; 45 (4): 327-339

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Subintimal angioplasty: an alternative to open surgery of the lower limb chronic artery occlusion

Nerijus Aleksynas1, 2, Rytis Kaupas3, Aleksandras Antuševas1

1Department of Cardiac, Thoracic, and Vascular Surgery, 2Institute for Biomedical Research, 3Department of Radiology, Kaunas University of Medicine, Lithuania

Key words: chronic arterial occlusion; definition of subintimal angioplasty, indications; contraindications; methodology; results; bypass operations.

Summary. Objective. Based on recent literature data, subintimal arterial angioplasty, its indications and contraindications, methods and techniques, treatment results, and perspectives are introduced in this article.

During the last two decades, with increasing human lifespan, more and more frequently a combination of progressive chronic lower limb ischemia, which is caused by occlusive disease, and severe condition occurs. In such cases, patients cannot be operated on. In Europe and the United States of America, patients undergo subintimal angioplasty. It is a minimally invasive technique for the treatment of lower limb occlusive disease, when without tissue incision, under local anesthesia, blood flow through damaged artery is normalized. Thus, the occlusion is removed without surgery, patient’s quality of life is improved, and survival is increased.

Correspondence to N. Aleksynas, Department of Cardiac, Thoracic, and Vascular Surgery, Kaunas University of Medicine, Eivenių 2, 50009 Kaunas, Lithuania. E-mail:

Received 23 January 2009, accepted 3 April 2009