Percutaneous intentional extraluminal revascularization

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Percutaneous intentional extraluminal revascularization
Specialtyinterventional radiology

Percutaneous intentional extraluminal revascularization (PIER) is a percutaneous technique used in interventional radiology for limb salvage in patients with lower limb ischemia due to long superficial femoral artery occlusions. This method is intended for those patients who make poor candidates for infrainguinal arterial bypass surgery.[1] A guide wire[2] is intentionally introduced in the subintimal space, after which balloon dilatation is performed to create a new lumen for the blood to flow through.[3] The technique is not without complications but may serve as a "temporary bypass" to provide wound healing and limb salvage.[4]

See also[edit]


  1. ^ Spinosa DJ, Leung DA, Matsumoto AH, Bissonette EA, Cage D, Harthun NL, Kern JA, Angle JF, Hagspiel KD, Crosby IK, Wellons HA, Tribble CG, Hartwell GD (2004). "Percutaneous intentional extraluminal recanalization in patients with chronic critical limb ischemia". Radiology. 232 (2): 499–507. doi:10.1148/radiol.2322030729. PMID 15286320.
  2. ^ Prakash Krishnan (2014-10-17). Peripheral Vascular Disease, An Issue of Interventional Cardiology Clinics,. Elsevier Health Sciences. pp. 2–. ISBN 978-0-323-32617-9.
  3. ^ Jack L. Cronenwett; K. Wayne Johnston (2014-03-12). Rutherford's Vascular Surgery. Elsevier Health Sciences. pp. 1782–. ISBN 978-0-323-24306-3.
  4. ^ Met R, Van Lienden KP, Koelemay MJ, Bipat S, Legemate DA, Reekers JA (2008). "Subintimal angioplasty for peripheral arterial occlusive disease: a systematic review". Cardiovasc Intervent Radiol. 31 (4): 687–97. doi:10.1007/s00270-008-9331-7. PMC 2515568. PMID 18414946.

Further reading[edit]

  • Reekers, JA; Bolia, A (Oct 1998). "Percutaneous intentional extraluminal (subintimal) recanalization: how to do it yourself". European journal of radiology. 28 (3): 192–8. PMID 9881251.