The outcome of a combination of superficial femoral artery angioplasty with infragenicular angioplasty in the treatment of critical lower limb ischemia

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Abstract

Background/aim
As endovascular disease with significant femoropopliteal or infragenicular arterial lesions largely affects the outcome in critical limb ischemia (CLI), the aim of this study is to examine the impact of dealing with distal outflow infragenicular arterial lesions on the outcome of CLI in terms of patency and limb salvage rates.
Patients and methods
A prospective study was carried out of all endovascular interventions performed for patients with CLI encountering femoropopliteal and tibial arterial lesions between February 2012 and January 2014; the patients were randomly divided into two groups. The first group included patients who received a concomitant tibial intervention and the second group included those who received femoropopliteal interventions alone. The duration of follow-up was 12 months, which was within the period of this study.
Results
Endovascular procedures were used to treat 54 patients with a runoff score of greater than 10. The first group included 29 patients and the second group included 25 patients with CLI. Primary success reached 89.6% in the first group and 96% in the second group. Primary patency rates at 12 months were 59 and 51% in both groups, respectively, whereas secondary patency rates at 12 months were 70 and 52% in both groups, respectively, with no statistically significant difference. The limb salvage rate over 12 months was better in the first group (83%) than in the second group (76%).
Conclusion
Although simultaneous superficial femoral artery with tibial angioplasty did not yield a significant increase in patency rates, the better limb salvage rates make interventional treatment for infragenicular arteries a key part of the vascular specialist armamentarium when treating CLI.

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Journal of the Arab Society for Medical Research
Volume 9, Issue 1
January 2014
Pages 23-27

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