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| Michael J Glasby is a
consultant interventional
radiologist at the Derby
Royal Infirmary, UK, with
special interests in vascular
intervention and EVAR. He
qualified from University
College London Medical School
in 1991. After initially training
in surgery, he made the change
to radiology. He studied
radiology at the University
Hospitals of Leicester, UK
and spent an additional 2
years working under Dr. Bolia
– who pioneered subintimal
angioplasty – at the Leicester
Royal Infirmary. |
Subintimal angioplasty
Michael J. Glasby,1 George Markose2
and Amman Bolia2
1Derby Royal Infirmary, London Road, Derby, UK
2Leicester Royal Infirmary, Infirmary Square, Leicester, UK
Address for correspondence:
Dr. Michael J. Glasby MBBS BSc MRCS FRCR
X-ray Department, Derby Royal Infirmary
London Road, Derby DE1 2QY, UK
Tel: +44 (0)1332-340131
Email: mike.glasby@derbyhospitals.nhs.uk
Abstract
The technique of subintimal angioplasty (SIA) has
been in use for approximately two decades and is a
suitable alternative to bypass surgery. It was originally
described in the femoro-popliteal arteries but its scope
has been extended to occluded vessels throughout the
body from crural vessels to visceral arteries. SIA is a
straightforward and easy technique to master but there
is a learning curve. The procedure is well tolerated
with a low complication rate and is comparable to
conventional angioplasty. Initial technical success
rates are high (74–92%). Reported long-term patency
rates are variable but assisted patency rates can be as
high as 64% at 5 years. In cases where SIA has failed,
repeated studies show that it does not jeopardise
future surgery. The procedure of SIA is still evolving:
recent developments include devices to aid re-entry
back to the true lumen and stent technology to assist
long-term patency rates.
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