title: Percutaneous transluminal angioplasty in the treatment of critical limb ischemia.
abstract: 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.
authors.affiliation: Department of Vascular and Endovascular Surgery, Leicester Royal Infirmary, Leicester, England, UK. kevmolloy66@hotmail.com
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Molloy
authors.forename: Akhtar
authors.initials: A
authors.lastname: Nasim
authors.forename: Nick J M
authors.initials: NJ
authors.lastname: London
authors.forename: A Ross
authors.initials: AR
authors.lastname: Naylor
authors.forename: Peter R F
authors.initials: PR
authors.lastname: Bell
authors.forename: Guy
authors.initials: G
authors.lastname: Fishwick
authors.forename: Amman
authors.initials: A
authors.lastname: Bolia
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Thompson
mesh_terms: 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