Abstract
•
Dedicated below-the-ankle (BTA) angiography and revascularization is underutilized in ischemic foot treatment. Existing guidelines do not address comprehensive BTA vessel analysis. CLTI trials also often lack data on in-line arterial flow to the ischemic lesion and BTA vessel evaluation, hindering outcome assessment.
•
Dedicated multi-planar angiographic evaluation of the distal microcirculation is key: Direct arterial flow or good-quality collaterals are crucial in influencing wound healing and need to be assessed diligently to the level of the distal ischemic wound territory, termed “woundosome.”
•
An important primary emphasis of future trials should be on validating technologies and strategies for assessing tissue perfusion before, during, and after revascularization undertaken to heal tissue loss in CLTI patients. This will allow determination of a potentially significant delta in tissue perfusion prior to and following intervention at the “woundosome” level. Once changes in arterial perfusion have been identified as positively correlated to wound healing, these could serve as a much-needed novel primary technical outcome measure for patients with tissue loss undergoing surgical, hybrid, or endovascular revascularization.
| Original language | English |
|---|---|
| Journal | Journal of Endovascular Therapy |
| ISSN | 1526-6028 |
| DOIs | |
| Publication status | Accepted/In press - 2024 |
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The “Woundosome” Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia. / Patrone, Lorenzo; Pasqui, Edoardo; Conte, Michael S.; Farber, Alik; Ferraresi, Roberto; Menard, Matthew; Mills, Joseph L.; Rundback, John; Schneider, Peter; Ysa, August; Abhishek, Kumar; Adams, George L.; Ahmad, Naseer; Ahmed, Irfan; Alexandrescu, Vlad A.; Amor, Max; Alper, David; Andrassy, Martin; Attinger, Christopher; Baadh, Andy; Barakat, Hashem; Biasi, Lukla; Bisdas, Theodosios; Bhatti, Zagum; Blessing, Erwin; Bonaca, Marc P.; Bonvini, Stefano; Bosiers, Michel; Bradbury, Andrew W.; Beasley, Robert; Behrendt, Christian Alexander; Brodmann, Marianne; Cabral, Gonzalo; Cancellieri, Roberto; Casini, Andrea; Chandra, Venita; Chisci, Emiliano; Chohan, Omar; Choke, Edward T.C.; Chong, Patrick F.S.; Clerici, Giacomo; Coscas, Raphael; Costantino, Mary; Dalla Paola, Luca; Dand, Sabeen; Davies, Robert S.M.; D’Oria, Mario; Diamantopoulos, Athanasios; Debus, Sebastian; Deloose, Koen; Del Giudice, Costantino; Donato, Gianmarco de; Rubertis, Brian De; Paul De Vries, Jean; Dias, Nuno V.; Diaz-Sandoval, Larry; Dick, Florian; Donas, Konstantinos; Dua, Anahita; Fanelli, Fabrizio; Fazzini, Stefano; Foteh, Mazin; Gandini, Roberto; Gargiulo, Mauro; Garriboli, Luca; Genovese, Elizabeth A.; Gifford, Edward; Goueffic, Yann; Goverde, Peter; Chand Gupta, Prem; Hinchliffe, Robert; Holden, Andrew; Houlind, Kim C.; Howard, Dominic P.J.; Huasen, Bella; Isernia, Giacomo; Katsanos, Konstantinos; Katzen, Barry; Kolh, Philippe; Koncar, Igor; Korosoglou, Grigorios; Krishnan, Prakash; Kroencke, Thomas; Krokidis, Miltiadis; Kumarasamy, Arun; Hayes, Paul; Iida, Osamu; Alejandre Lafont, Enrique; Langhoff, Ralf; Lecis, Alexandre; Lessne, Mark; Lichaa, Hady; Lichtenberg, Michael; Lobato, Marta; Lopes, Alice; Loreni, Giorgio; Lucatelli, Pierleone; Madassery, Sreekumar; Maene, Lieven; Manzi, Marco; Maresch, Martin; Santhosh Mathews, Jay; McCaslin, James; Micari, Antonio; Michelagnoli, Stefano; Migliara, Bruno; Morgan, Robert; Morelli, Luis; Morosetti, Daniele; Mouawad, Nicolas; Moxey, Paul; Müller-Hülsbeck, Stefan; Mustapha, Jihad; Nakama, Tatsuya; Nasr, Bahaa; N’dandu, Zola; Neville, Richard; Noory, Elias; Nordanstig, Joakim; Noronen, Katariina; Mariano Palena, Luis; Parlani, Gianbattista; Patel, Ashish S.; Patel, Parag; Patel, Rafiuddin; Patel, Sanjay; Pena, Costantino; Perkov, Drazen; Portou, Mark; Pratesi, Giovanni; Rammos, Christos; Reekers, Jim; Riambau, Vicente; Roy, Trisha; Rosenfield, Kenneth; Antonella Ruffino, Maria; Saab, Fadi; Saratzis, Athanasios; Sbarzaglia, Paolo; Schmidt, Andrej; Secemsky, Eric; Siah, Michael; Sillesen, Henrik; Simonte, Gioele; Sirvent, Marc; Sommerset, Jill; Steiner, Sabine; Sakr, Ahmed; Scheinert, Dierk; Shishebor, Mehdi; Spiliopoulos, Stavros; Spinelli, Alessio; Stravoulakis, Konstantinos; Taneva, Gergana; Teso, Desarom; Tessarek, Joerg; Theivacumar, Selva; Thomas, Anish; Thomas, Shannon; Thulasidasan, Narayan; Torsello, Giovanni; Tripathi, Ramesh; Troisi, Nicola; Tummala, Srini; Tummala, Venkat; Twine, Christopher; Uberoi, Raman; Ucci, Alessandro; Valenti, Domenico; van den Berg, Jos; van den Heuvel, Daniel; Van Herzeele, Isabelle; Varcoe, Ramon; Vega de Ceniga, Melina; Veith, Frank J.; Venermo, Maarit; Vijaynagar, Badri; Virdee, Sanjiv; Von Stempel, Conrad; Voûte, Michiel T.; Khee Yeung, Kak; Zeller, Thomas; Zayed, Hany; Montero Baker, Miguel.
In: Journal of Endovascular Therapy, 2024.Research output: Contribution to journal › Editorial › Research › peer-review
}
TY - JOUR
T1 - The “Woundosome” Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia
AU - Patrone, Lorenzo
AU - Pasqui, Edoardo
AU - Conte, Michael S.
AU - Farber, Alik
AU - Ferraresi, Roberto
AU - Menard, Matthew
AU - Mills, Joseph L.
AU - Rundback, John
AU - Schneider, Peter
AU - Ysa, August
AU - Abhishek, Kumar
AU - Adams, George L.
AU - Ahmad, Naseer
AU - Ahmed, Irfan
AU - Alexandrescu, Vlad A.
AU - Amor, Max
AU - Alper, David
AU - Andrassy, Martin
AU - Attinger, Christopher
AU - Baadh, Andy
AU - Barakat, Hashem
AU - Biasi, Lukla
AU - Bisdas, Theodosios
AU - Bhatti, Zagum
AU - Blessing, Erwin
AU - Bonaca, Marc P.
AU - Bonvini, Stefano
AU - Bosiers, Michel
AU - Bradbury, Andrew W.
AU - Beasley, Robert
AU - Behrendt, Christian Alexander
AU - Brodmann, Marianne
AU - Cabral, Gonzalo
AU - Cancellieri, Roberto
AU - Casini, Andrea
AU - Chandra, Venita
AU - Chisci, Emiliano
AU - Chohan, Omar
AU - Choke, Edward T.C.
AU - Chong, Patrick F.S.
AU - Clerici, Giacomo
AU - Coscas, Raphael
AU - Costantino, Mary
AU - Dalla Paola, Luca
AU - Dand, Sabeen
AU - Davies, Robert S.M.
AU - D’Oria, Mario
AU - Diamantopoulos, Athanasios
AU - Debus, Sebastian
AU - Deloose, Koen
AU - Del Giudice, Costantino
AU - Donato, Gianmarco de
AU - Rubertis, Brian De
AU - Paul De Vries, Jean
AU - Dias, Nuno V.
AU - Diaz-Sandoval, Larry
AU - Dick, Florian
AU - Donas, Konstantinos
AU - Dua, Anahita
AU - Fanelli, Fabrizio
AU - Fazzini, Stefano
AU - Foteh, Mazin
AU - Gandini, Roberto
AU - Gargiulo, Mauro
AU - Garriboli, Luca
AU - Genovese, Elizabeth A.
AU - Gifford, Edward
AU - Goueffic, Yann
AU - Goverde, Peter
AU - Chand Gupta, Prem
AU - Hinchliffe, Robert
AU - Holden, Andrew
AU - Houlind, Kim C.
AU - Howard, Dominic P.J.
AU - Huasen, Bella
AU - Isernia, Giacomo
AU - Katsanos, Konstantinos
AU - Katzen, Barry
AU - Kolh, Philippe
AU - Koncar, Igor
AU - Korosoglou, Grigorios
AU - Krishnan, Prakash
AU - Kroencke, Thomas
AU - Krokidis, Miltiadis
AU - Kumarasamy, Arun
AU - Hayes, Paul
AU - Iida, Osamu
AU - Alejandre Lafont, Enrique
AU - Langhoff, Ralf
AU - Lecis, Alexandre
AU - Lessne, Mark
AU - Lichaa, Hady
AU - Lichtenberg, Michael
AU - Lobato, Marta
AU - Lopes, Alice
AU - Loreni, Giorgio
AU - Lucatelli, Pierleone
AU - Madassery, Sreekumar
AU - Maene, Lieven
AU - Manzi, Marco
AU - Maresch, Martin
AU - Santhosh Mathews, Jay
AU - McCaslin, James
AU - Micari, Antonio
AU - Michelagnoli, Stefano
AU - Migliara, Bruno
AU - Morgan, Robert
AU - Morelli, Luis
AU - Morosetti, Daniele
AU - Mouawad, Nicolas
AU - Moxey, Paul
AU - Müller-Hülsbeck, Stefan
AU - Mustapha, Jihad
AU - Nakama, Tatsuya
AU - Nasr, Bahaa
AU - N’dandu, Zola
AU - Neville, Richard
AU - Noory, Elias
AU - Nordanstig, Joakim
AU - Noronen, Katariina
AU - Mariano Palena, Luis
AU - Parlani, Gianbattista
AU - Patel, Ashish S.
AU - Patel, Parag
AU - Patel, Rafiuddin
AU - Patel, Sanjay
AU - Pena, Costantino
AU - Perkov, Drazen
AU - Portou, Mark
AU - Pratesi, Giovanni
AU - Rammos, Christos
AU - Reekers, Jim
AU - Riambau, Vicente
AU - Roy, Trisha
AU - Rosenfield, Kenneth
AU - Antonella Ruffino, Maria
AU - Saab, Fadi
AU - Saratzis, Athanasios
AU - Sbarzaglia, Paolo
AU - Schmidt, Andrej
AU - Secemsky, Eric
AU - Siah, Michael
AU - Sillesen, Henrik
AU - Simonte, Gioele
AU - Sirvent, Marc
AU - Sommerset, Jill
AU - Steiner, Sabine
AU - Sakr, Ahmed
AU - Scheinert, Dierk
AU - Shishebor, Mehdi
AU - Spiliopoulos, Stavros
AU - Spinelli, Alessio
AU - Stravoulakis, Konstantinos
AU - Taneva, Gergana
AU - Teso, Desarom
AU - Tessarek, Joerg
AU - Theivacumar, Selva
AU - Thomas, Anish
AU - Thomas, Shannon
AU - Thulasidasan, Narayan
AU - Torsello, Giovanni
AU - Tripathi, Ramesh
AU - Troisi, Nicola
AU - Tummala, Srini
AU - Tummala, Venkat
AU - Twine, Christopher
AU - Uberoi, Raman
AU - Ucci, Alessandro
AU - Valenti, Domenico
AU - van den Berg, Jos
AU - van den Heuvel, Daniel
AU - Van Herzeele, Isabelle
AU - Varcoe, Ramon
AU - Vega de Ceniga, Melina
AU - Veith, Frank J.
AU - Venermo, Maarit
AU - Vijaynagar, Badri
AU - Virdee, Sanjiv
AU - Von Stempel, Conrad
AU - Voûte, Michiel T.
AU - Khee Yeung, Kak
AU - Zeller, Thomas
AU - Zayed, Hany
AU - Montero Baker, Miguel
PY - 2024
Y1 - 2024
N2 - This editorial assembles endovascular specialists from diverse clinical backgrounds and nationalities with a global call to address key challenges to enhance revascularization in chronic limb-threatening ischemia (CLTI) patients.• Dedicated below-the-ankle (BTA) angiography and revascularization is underutilized in ischemic foot treatment. Existing guidelines do not address comprehensive BTA vessel analysis. CLTI trials also often lack data on in-line arterial flow to the ischemic lesion and BTA vessel evaluation, hindering outcome assessment.• Dedicated multi-planar angiographic evaluation of the distal microcirculation is key: Direct arterial flow or good-quality collaterals are crucial in influencing wound healing and need to be assessed diligently to the level of the distal ischemic wound territory, termed “woundosome.”• An important primary emphasis of future trials should be on validating technologies and strategies for assessing tissue perfusion before, during, and after revascularization undertaken to heal tissue loss in CLTI patients. This will allow determination of a potentially significant delta in tissue perfusion prior to and following intervention at the “woundosome” level. Once changes in arterial perfusion have been identified as positively correlated to wound healing, these could serve as a much-needed novel primary technical outcome measure for patients with tissue loss undergoing surgical, hybrid, or endovascular revascularization.
AB - This editorial assembles endovascular specialists from diverse clinical backgrounds and nationalities with a global call to address key challenges to enhance revascularization in chronic limb-threatening ischemia (CLTI) patients.• Dedicated below-the-ankle (BTA) angiography and revascularization is underutilized in ischemic foot treatment. Existing guidelines do not address comprehensive BTA vessel analysis. CLTI trials also often lack data on in-line arterial flow to the ischemic lesion and BTA vessel evaluation, hindering outcome assessment.• Dedicated multi-planar angiographic evaluation of the distal microcirculation is key: Direct arterial flow or good-quality collaterals are crucial in influencing wound healing and need to be assessed diligently to the level of the distal ischemic wound territory, termed “woundosome.”• An important primary emphasis of future trials should be on validating technologies and strategies for assessing tissue perfusion before, during, and after revascularization undertaken to heal tissue loss in CLTI patients. This will allow determination of a potentially significant delta in tissue perfusion prior to and following intervention at the “woundosome” level. Once changes in arterial perfusion have been identified as positively correlated to wound healing, these could serve as a much-needed novel primary technical outcome measure for patients with tissue loss undergoing surgical, hybrid, or endovascular revascularization.
U2 - 10.1177/15266028241231745
DO - 10.1177/15266028241231745
M3 - Editorial
C2 - 38523459
AN - SCOPUS:85188516237
JO - Journal of Endovascular Therapy
JF - Journal of Endovascular Therapy
SN - 1526-6028
ER -