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.
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 (interquartile
range: 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.
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