Long-term results: tibial angioplasty in critical limb ischemia

ABSTRACT

Patients with CLI are typically elderly with multiple co-morbidity and limited life expectancy and therefore, a procedure, which is minimally invasive with reduced morbidity and mortality but lesser long-term patency, may be more appropriate than a more invasive procedure with better long-term patency. This study was conducted to assess the outcome of endovascular angioplasty in treating infragenicular arterial disease in Egyptian diabetic patients with critical limb ischemia. Forty nine patients with [51] limbs presented with critical limb ischemia were subjected to endovascular tibial angioplasty, of which 40 patients had gangrene, 6 patients had ischemic ulcers, 3 had rest pain and 2 with severe foot infections. Overall, 79 arteries of the infra-popliteal [7] and iliac [1] were associated. Technical success was evaluated on angiography at the end of the procedure revascularization of at least one of 3 leg vessels with re-establishment of arterial flow to the foot was regarding technical success. The technical success rate of angioplasty in the revascularization of infra-popliteal vessles was 92%. In the 4 [8%] patients with a technical failure, two patients were treated conservatively and two patients were lost to follow up during the study. The clinical success rate was [80%], healing of an ulcer or wound after minor amputation. The cumulative limb salvage rate quantified by Kaplan-Meier life table analysis was at 20 month 80%. The per-cutaneous tibial angioplasty of infra-popliteal artery stenoses and occlusions is considered as an effective and safe therapy modality to avoid below the-knee amputation in patients with limb threatening ischemia