Clinical Outcome Following Infra-Inguinal Percutaneous Transluminal Angioplasy for Critical Limb Ischemia

Journal Article · Sun Jun 15 04:00:00 EDT 2003 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-003-0007-Z· OSTI ID:21088378

Matsagas, Miltiadis I; Rivera, Marco A ^[1]; Tran, Tan ^[2]; Mitchell, Adam ^[3]; Robless, Peter ^[1]; Davies, Alun H ^[4]; Geroulakos, George ^[1]

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1. Ealing Hospital, Uxbridge Road, Southall, Middlesex, UB13HW, London, Vascular Unit, Department of Surgery (United Kingdom)
2. EalingHospital, Uxbridge Road, Southall, Middlesex, UB1 3HW, London, Department of Radiology (United Kingdom)
3. Charing Cross Hospital, London, Department of Radiology (United Kingdom)
4. Imperial College School of Medicine, Charing Cross Hospital, London, Departmentof Vascular Surgery (United Kingdom)

Objective: The aim of this study was to assess the efficacy and durability of infra-inguinal PTA in patients with CLI, in terms of clinical outcome. Design:Retrospective study of 50 consecutive patients with CLI that were exclusively treated by infra-inguinal PTA. Methods: The indications for intervention were rest pain in seven (14%) patients,non-healing ulcers in 27 (54%), and gangrenous lesions in 16 (32%).Thirty-three (66%) of these patients presented with a single arterial lesion, and the remaining 17 (34%) with multilevel arterial lesions.Kaplan-Meier analysis was used to assess survival, patency,limb-salvage rates, and amputation-free survival. Results: A total of 67 endovascular procedures were performed and 59 (88.1%) of them were considered to be technically successful. The median follow-up period was 12 months (interquartilerange: 17 months). The 30-day mortality was 4%, while the cumulative survival rates at 12, 24, and 36 months were 73%, 67%, and 59%,respectively. The cumulative primary patency rates at 12 and 24 months were 63% and 52%, respectively, and remained unchanged thereafter.The estimated secondary patency rate was 72% at 36 months. There was only one below-knee amputation in the patients that were treated exclusively with infra-inguinal PTA. The cumulative amputation-free survival at the same period was estimated at 60%. Conclusions: Infra-inguinal PTA had a good early and late outcome in this series of patients with a limited life expectancy.These results are comparable to historical results of surgical revascularization in the treatment of CLI. There is need for a randomized study to determine the primary optimal interventional approach for patients with CLI.

• OSTI ID: 21088378
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 3 Vol. 26; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BONE JOINTS
HEALING
ISCHEMIA
LIMBS
PAIN
PATIENTS
ULCERS