Academic Journal
Impact of ultrasound-guided popliteal sciatic nerve block on endovascular therapy for below-the-knee lesions in chronic limb-threatening ischemia.
| Title: | Impact of ultrasound-guided popliteal sciatic nerve block on endovascular therapy for below-the-knee lesions in chronic limb-threatening ischemia. |
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| Authors: | Suzuki R; Department of Cardiology, Sapporo City General Hospital, Sapporo, Japan. Electronic address: rs.3535.dng@gmail.com., Dannoura Y; Department of Cardiology, Sapporo City General Hospital, Sapporo, Japan., Makino T; Department of Cardiology, Sapporo City General Hospital, Sapporo, Japan., Yokoshiki H; Department of Cardiology, Sapporo City General Hospital, Sapporo, Japan. |
| Source: | Journal of vascular surgery [J Vasc Surg] 2026 Jun; Vol. 83 (6), pp. 1622-1629.e1. Date of Electronic Publication: 2026 Feb 09. |
| Publication Type: | Journal Article; Observational Study |
| Language: | English |
| Journal Info: | Publisher: Elsevier Country of Publication: United States NLM ID: 8407742 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6809 (Electronic) Linking ISSN: 07415214 NLM ISO Abbreviation: J Vasc Surg Subsets: MEDLINE |
| Imprint Name(s): | Publication: <2008-> : New York, NY : Elsevier Original Publication: St. Louis, Mo. : Mosby, [c1984- |
| MeSH Terms: | Ischemia*/therapy , Ischemia*/physiopathology , Ischemia*/diagnostic imaging , Peripheral Arterial Disease*/therapy , Peripheral Arterial Disease*/physiopathology , Peripheral Arterial Disease*/diagnostic imaging , Nerve Block*/adverse effects , Nerve Block*/methods , Endovascular Procedures*/adverse effects , Ultrasonography, Interventional* , Sciatic Nerve*, Humans ; Male ; Aged ; Retrospective Studies ; Female ; Treatment Outcome ; Aged, 80 and over ; Middle Aged ; Time Factors ; Chronic Disease ; Adult ; Risk Factors ; Popliteal Artery |
| Abstract: | Objective: This study aimed to investigate the impact of ultrasound-guided popliteal sciatic nerve block (PSNB) on the outcomes of endovascular therapy (EVT) for below-the-knee (BTK) lesions in patients with chronic limb-threatening ischemia (CLTI). Methods: This single-center retrospective observational study enrolled 180 consecutive patients with CLTI (median age, 75 years [interquartile range (IQR), 43-95 years]; male, 77.8%; diabetes mellitus, 66.7%; dialysis, 52.8%) who underwent EVT for BTK lesions between July 2024 and June 2025. PSNB was introduced at our institution in March 2025. We compared 73 consecutive patients treated with PSNB from March to June 2025 (PSNB group) with 107 consecutive patients treated without PSNB from July 2024 to February 2025 (non-PSNB group). The end points included technical success, procedure time, failure rate of digital subtraction angiography owing to leg motion, contrast volume, radiation exposure (cumulative dose-area product), and PSNB-related complications. Propensity score matching was performed to reduce the baseline differences. Results: Propensity score matching extracted 65 pairs with no significant baseline differences between the groups. There was no significant difference in technical success between the PSNB and non-PSNB groups (96.9% vs 96.9%; P > .99). The total room time was comparable (57 minutes [IQR, 28-157 minutes] vs 60 minutes [IQR, 22-190 minutes]; P = .26), but the procedure time from puncture to sheath removal was significantly shorter in the PSNB group (46minutes [IQR, 14-149minutes] vs 53 minutes [IQR, 18-184 minutes]; P = .02). The median duration required to perform PSNB was 7 minutes (IQR, 2-15 minutes). The failure rate of digital subtraction angiography imaging owing to leg movement was significantly lower in the PSNB group (18.5% vs 53.8%; P < .001). Although contrast volume tended to be lower in the PSNB group (51 mL [IQR, 0-210 mL] vs 65 mL [IQR, 13-241 mL]; P = .22), the cumulative dose-area product was significantly lower in the PSNB group (7.1 Gy·cm2 [IQR, 1.7-32.7 Gy·cm2] vs 8.6 Gy·cm2 [IQR, 2.5-69.6 Gy·cm2]; P = .02). No PSNB-related complications were observed. Conclusions: Ultrasound-guided PSNB appears to be a safe and effective adjunct during EVT for BTK lesions in CLTI, contributing to shorter procedure times, improved imaging success by minimizing leg movement, and decreased radiation exposure. (Copyright © 2026 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.) |
| Competing Interests: | Disclosures None. |
| Contributed Indexing: | Keywords: Chronic limb-threatening ischemia; Endovascular therapy; Popliteal sciatic nerve block |
| Entry Date(s): | Date Created: 20260211 Date Completed: 20260707 Latest Revision: 20260727 |
| Update Code: | 20260728 |
| DOI: | 10.1016/j.jvs.2026.01.038 |
| PMID: | 41672334 |
| Database: | MEDLINE |
| ISSN: | 1097-6809 |
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| DOI: | 10.1016/j.jvs.2026.01.038 |