Clinical Outcome Following Infra-Inguinal Percutaneous Transluminal Angioplasy for Critical Limb Ischemia
- Ealing Hospital, Uxbridge Road, Southall, Middlesex, UB13HW, London, Vascular Unit, Department of Surgery (United Kingdom)
- EalingHospital, Uxbridge Road, Southall, Middlesex, UB1 3HW, London, Department of Radiology (United Kingdom)
- Charing Cross Hospital, London, Department of Radiology (United Kingdom)
- 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, Vol. 26, Issue 3; Other Information: DOI: 10.1007/s00270-003-0007-z; Copyright (c) 2003 Springer-Verlag New York, Inc.; www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
- Country of Publication:
- United States
- Language:
- English
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