title: Comparison of results in endovascular interventions for infrainguinal lesions: claudication versus critical limb ischemia.
abstract: This study analyzed clinical success, patency, and limb salvage after endovascular repair in patients treated for chronic limb ischemia presenting with claudication versus critical limb ischemia. Between October 2001 and August 2004, 115 patients (mean age 71) underwent endovascular treatment for infrainguinal arterial disease. Techniques included subintimal angioplasty and transluminal angioplasty with or without stents. Lesions were classified according to Transatlantic InterSociety Consensus. Follow-up (mean 11 months) included physical exam, ankle-brachial index, and duplex ultrasound. Patency rates were determined using Kaplan-Meier and compared by log-rank analysis. One hundred ninety-nine lesions were treated in 121 limbs using percutaneous techniques. Comorbidities were similar except higher rates of diabetes mellitus (67% vs 41%, P < 0.001) and chronic renal insufficiency (22% vs 7%, P < 0.05) were found in critical limb ischemia patients. Primary patency for claudicants was 100 per cent, 98 per cent, and 85 per cent at 3, 6, and 12 months and 89 per cent, 80 per cent, and 72 per cent for critical limb ischemia, respectively (P = 0.06). Limb salvage was 91 per cent at 12 months for critical limb ischemia patients. Morbidity was similar between groups, and there was no perioperative mortality. Percutaneous intervention for both claudication and critical limb ischemia provides acceptable 12 month patency with limited morbidity.
authors.affiliation: Division of Vascular Surgery, New York Presbyterian Hospital, Cornell University, New York, New York 10021, USA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Trocciola
authors.forename: Rabih
authors.initials: R
authors.lastname: Chaer
authors.forename: Rajeev
authors.initials: R
authors.lastname: Dayal
authors.forename: Stephanie C
authors.initials: SC
authors.lastname: Lin
authors.forename: Naveen
authors.initials: N
authors.lastname: Kumar
authors.forename: Jason
authors.initials: J
authors.lastname: Rhee
authors.forename: Matthew
authors.initials: M
authors.lastname: Pierce
authors.forename: Evan J
authors.initials: EJ
authors.lastname: Ryer
authors.forename: James
authors.initials: J
authors.lastname: McKinsey
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Morrissey
authors.forename: Harry L
authors.initials: HL
authors.lastname: Bush
authors.forename: K Craig
authors.initials: KC
authors.lastname: Kent
authors.forename: Peter L
authors.initials: PL
authors.lastname: Faries
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000379:methods* / Q000401:mortality; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D007264:Inguinal Canal; D007383:Intermittent Claudication / Q000000981:diagnostic imaging / Q000628:therapy*; D007511:Ischemia / Q000000981:diagnostic imaging / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D023821:Limb Salvage / Q000379:methods; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D011859:Radiography; D012042:Registries; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology