Tibial corticotomy and periosteal elevation for chronic critical lower limb ischaemia

ABSTRACT

Estimating procedure's safety, efficiency, efficacy and cost/benefit. Thirty six patients were enrolled. Preoperative demographic data, ankle systolic pressure, and magnetic resonance angiography were obtained. Early results [1st month] included skin perfusion and pain, late results involved wound healing, pain, Kelker score, procedure morbidity, patient satisfaction and quality of life. Mean age SD was 68.03 5.5, males were 23[63.9%], twenty [55.6%] patients had ankle systolic pressure 50 mmHg and 29 [80.5%] with infrainguinal disease. Within the 1st month; skin perfusion and rest pain improved in 91.7%, 86.1%, patients respectively. Magnetic resonance angiography at the 2nd month declared vascular response for all patients. By the end of 1st year 34 [94.4%] patients achieved complete wound healing, also rest pain and claudication relief occurred in 86.1% and 55.6% patients, with 20 [55.6%] patients had excellent score. Procedure morbidity was [17.7%]. Satisfaction measures at six and twelfth months were "mean SD" 7.1, 1.3, 8.7, 1.7 respectively. Twelfth month quality of life improved [overall score P = 0.05, mental health scale < 0.05 and pain/anxiety domain P < 0.001]. The procedure represents an invaluable tool to be evaluated in randomized study