Percutaneous transluminal angioplasty in the treatment of critical limb ischemia.
OBJECTIVE
To assess the role of percutaneous transluminal angioplasty (PTA) to treat critical limb ischemia (CLI) and to relate the changing experience with endovascular treatment of this condition in a major vascular unit.


METHODS
A prospective study was performed involving 110 consecutive patients (57 women; mean age 76 years, range 57-99) undergoing balloon angioplasty for critical limb ischemia in 133 limbs. Outcome at 1 year was examined by case note review or questionnaire to determine survival, amputation-free survival, limb salvage, and CLI recurrence.


RESULTS
Technical success was achieved in 105 (79%) of 133 limbs; the overall complication rate was 20% (3.8% major, 16.2% minor). The median follow-up was 15 months (minimum 12). The 12-month limb salvage rate by life-table analysis was 88%. Patients with an initially successful angioplasty had an extremely good outcome (95% 1-year limb salvage). In contrast, the 28 patients with failed angioplasty fared very poorly; a major amputation was required in 10, and death occurred in another 9, leaving only 9 survivors with limbs intact at 1 year.


CONCLUSIONS
The results of this study justify the continuing use of PTA as first-line treatment for critical limb ischemia.
Molloy
Kevin J
KJ
Department of Vascular and Endovascular Surgery, Leicester Royal Infirmary, Leicester, England, UK. kevmolloy66@hotmail.com
Nasim
Akhtar
A
London
Nick J M
NJ
Naylor
A Ross
AR
Bell
Peter R F
PR
Fishwick
Guy
G
Bolia
Amman
A
Thompson
Matthew M
MM
D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome