title: [Distal arteritis of the legs: endovascular treatment].
abstract: Femoro-tibial bypasses are not always feasible in patients presenting with "critical" chronic ischemia. The results of endovascular therapies carried out over a 2-year period are analyzed. Twenty-three patients with critical ischemia (rest pain 13%, gangrene 87%) had 25 procedures on 29 leg arteries: percutaneous transluminal angioplasty in 17 arteries, rotational atherectomy in 10 arteries, laser recanalization (1 artery), directional atherectomy (1 artery). The hospital mortality rate was 4.3%. The cumulative patency and limb salvage rates were respectively 51% and 77% at 6 months, 34% and 71% at 12 months. Candidates for tibial-peroneal endovascular techniques should have a threatened limb, as long as the consequences of failed procedures on patients presenting with claudication can be disastrous, and as long as mid-term patency rates reported in the literature are not fair enough. In localized stenosis or short occlusions with adequate runoff, endovascular techniques are a good alternative to femorotibial bypasses for limb salvage. In diffuse lesions with no possibility of bypass, endovascular techniques can facilitate limb salvage, even if the mid-term arterial patency rate is poor. When conventional therapies cannot face critical ischemia, endovascular therapies can provide a fair limb salvage rate.
authors.affiliation: Clinique de la Défense, Nanterre.
authors.forename: J
authors.initials: J
authors.lastname: Marzelle
authors.forename: F
authors.initials: F
authors.lastname: Cormier
authors.forename: J M
authors.initials: JM
authors.lastname: Fichelle
authors.forename: J M
authors.initials: JM
authors.lastname: Cormier
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon; D016342:Angioplasty, Laser; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D001167:Arteritis / Q000628:therapy; D017073:Atherectomy; D005260:Female; D006801:Humans; D007511:Ischemia / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
vernacular_title: Artérite distale des membres inférieurs: traitement endovasculaire.