Korean Circ J.  2012 Apr;42(4):259-265. 10.4070/kcj.2012.42.4.259.

Clinical Outcomes of Infrapopliteal Angioplasty in Patients With Critical Limb Ischemia

• Ryu HM
• Kim JS
• Ko YG
• Hong MK
• Jang Y
• Choi D

• KMID: 2225019
• DOI: http://doi.org/10.4070/kcj.2012.42.4.259

Abstract

BACKGROUND AND OBJECTIVES
With recent advances in equipment and techniques, infrapopliteal angioplasty has shown results that are comparable to those of surgical bypass in patients with critical limb ischemia (CLI). In this study, we evaluated the efficacy and the feasibility of infrapopliteal angioplasty in patients with CLI.
SUBJECTS AND METHODS
Between March 2002 and May 2008, infrapopliteal angioplasty was performed on 118 limbs of 101 patients (79 males; mean age 66 years) with CLI (Rutherford category 4, 5 or 6). Freedom from reintervention, limb salvage, and overall survival were analyzed.
RESULTS
The median follow-up duration was 30 months. Initial technical and clinical success rates were 69.5% and 83.1%, respectively. No major complication requiring surgical intervention developed after angioplasty. Among 82 limbs with initial technical success, the rate of freedom from any reintervention at 2 years was 70.7% and that from limb salvage was 97.6%. Young age and Rutherford category 6 at initial presentation were independent predictors associated with poor 2 year primary patency in these patients with CLI. Overall survival at 1 year was 86.4% and that at 2 years 76.3%. A history of cerebrovascular accident was an independent predictor associated with poor 2 year survival in these patients.
CONCLUSION
Infrapopliteal angioplasty as a primary choice of treatment in CLI patients showed favorable clinical outcomes and feasibility.

Keyword

Ischemia; Limb salvage; Tibial arteries; Peroneal arteries; Angioplasty

MeSH Terms

Angioplasty
Extremities
Follow-Up Studies
Freedom
Humans
Ischemia
Limb Salvage
Stroke
Tibial Arteries

Figure

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  Fig. 1 Kaplan-Meier analysis shows primary patency (A) and limb salvage rate (B) during 2 year follow-up among patients with initial technical success. Primary patency at 2 years was 70.7%, and limb salvage rate at 2 years was 97.6%.

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  Fig. 2 Kaplan-Meier analysis shows overall survival during 2 year follow-up. Overall survival at 2 years was 76.3%.

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