title: Infra-inguinal percutaneous transluminal angioplasty for limb salvage: a retrospective analysis in a single center.
abstract: OBJECTIVE
  To review the feasibility of infra-inguinal angioplasty in the management of critical limb ischemia (CLI).
  
  
  METHODS
  Data on 221 patients with 230 critically ischemic limbs, treated with consecutive percutaneous transluminal angioplasty (PTA) at Helsinki University Central Hospital between January 2000 and December 2002 were collected and analyzed retrospectively. Patency, limb salvage, and survival rates were calculated on an intention-to-treat basis. Comparisons were done with univariate (Kaplan-Meier) and multivariate analysis (Cox regression).
  
  
  RESULTS
  Overall primary patency, secondary patency, limb salvage, and survival rates were 47%, 59%, 92%, and 76%, respectively, at 12 months. In the multivariate analysis, low toe pressure (< or =30 mmHg) was a significant risk factor for poor patency. Uremia with hemodialysis, low toe pressure (< or =30 mmHg), and hemodynamic failure of the endovascular procedure were found to increase significantly the risk of amputation. Uremia with hemodialysis, coronary artery disease, tissue loss as indication for PTA (Fontaine stage IV), and age over 70 years were all found to increase significantly the risk of death.
  
  
  CONCLUSIONS
  Infra-inguinal PTA is feasible in patients with CLI and resulted in good limb salvage.
authors.affiliation: Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland. elina.eskelinen@fimnet.fi
authors.forename: E
authors.initials: E
authors.lastname: Eskelinen
authors.forename: A
authors.initials: A
authors.lastname: Albäck
authors.forename: W D
authors.initials: WD
authors.lastname: Roth
authors.forename: K
authors.initials: K
authors.lastname: Lappalainen
authors.forename: P
authors.initials: P
authors.lastname: Keto
authors.forename: M
authors.initials: M
authors.lastname: Railo
authors.forename: A
authors.initials: A
authors.lastname: Eskelinen
authors.forename: M
authors.initials: M
authors.lastname: Lepäntalo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007264:Inguinal Canal / Q000098:blood supply*; D007383:Intermittent Claudication / Q000628:therapy*; D007511:Ischemia / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome