The increasing role of percutaneous transluminal angioplasty in the primary management of critical limb ischaemia.
OBJECTIVE
to review the current role and results of angioplasty in the management of critical limb ischaemia (CLI) in a single institution.


METHODS
data on 526 patients with 608 ischaemic limbs, treated between January 1994 and December 1999 was collected prospectively and analysed retrospectively. Patients were divided into 3 groups according to the date of presentation: group 1 (1994-95), group 2 (1996-97) and group 3 (1998-99). The groups were comparable in terms of demographics, mode of presentation and level of disease.


RESULTS
Revascularisation was attempted in 87%, 81% and 91% for groups 1, 2 and 3 respectively (NS). Primary percutaneous transluminal angioplasty (PTA) rates increased from 44% (1994-95) to 69% (1998-99) (p < 0.001), and surgical revascularisation rates decreased correspondingly (p<0.01). Overall cumulative patient survival and limb salvage rates were 82% and 89% for 1 year and 45% and 87% for 5 years, respectively. No statistically significant difference existed between the three groups regarding patient survival, limb salvage rates and mean hospital stay (19, 12 and 12 days, respectively).


CONCLUSIONS
PTA is increasingly replacing bypass surgery in the treatment of CLI, without compromising patient survival or limb salvage rates.
Nasr
M K
MK
Royal United Hospital, Combe Park, Bath BA1 3NG, U.K.
McCarthy
R J
RJ
Hardman
J
J
Chalmers
A
A
Horrocks
M
M
D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D000800:Angioplasty, Balloon; D003422:Critical Care; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000401:mortality / Q000628:therapy*; D007866:Leg / Q000098:blood supply* / Q000601:surgery*; D007902:Length of Stay; D023821:Limb Salvage; D008297:Male; D012008:Recurrence; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom