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Vol 10, No 2 (2008)
Published online: 2008-10-21

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Percutaneous balloon angioplasty in the treatment of critical limb ischemia with severe obstructive lesions in below-the-knee arteries - results of 1 year follow-up

Marek Krzanowski, Wojciech Bodzoń, Maciej Wandzilak, Paweł Maga, Andrzej Belowski
Chirurgia Polska 2008;10(2):67-76.


Background: Critical limb ischemia (CLI) has an ominous prognosis. Effective revascularization saves the limb, improves the quality of life and is cost-effective. While bypass surgery has dominated treatment for decades it can be offered to a limited subset of patients. Endovascular treatment is an alternative method of revascularization. The aim of the study was to assess mid-term results of percutaneous balloon angioplasty in patients with CLI and severe obstructive lesions in below-the-knee arteries.
Material and methods: This was an open, prospective 1-year observation of 120 CLI patients in whom 127 limbs were treated. The majority of patients were in Rutherford class 6, the minority in Rutherford class 4. Results: After 12 months 52 patients were still alive, did not present signs or symptoms of CLI and had the treated limb preserved (43%). 19 patients had died (16%) and there were 25 amputations (20%). However, the periprocedural complication rate was high (14%), with most of the complications being related to arterial puncture.
Conclusions: Percutaneous revascularization is justified in CLI patients with below-the-knee obstructive lesions not amenable to surgery. After one year, the results of endovascular treatment are far better than the reported results of conservative treatment. Modifications in endovascular procedure techniques may improve final results.

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