[Long-term results after balloon angioplasty of the crural artery].
OBJECTIVE
To evaluate the technical success rate, procedure-related complications, and clinical long-term results for patients who underwent infrapopliteal angioplasty.


METHODS
We retrospectively evaluated all patients who underwent infrapopliteal angioplasty to treat critical chronic limb ischemia or severe claudication from 1/1997 to 12/1999. We excluded patients with acute (< 2 weeks) limb ischemia. Procedure-related data were prospectively documented in a database and analyzed with a focus on the technical success rate and procedure-related complications. In addition all clinical documents were analyzed, and a follow-up examination was performed or telephone interviews were conducted with patients, relatives and referring doctors for follow-up. The primary end points were the limb salvage rate and patient survival rate. The secondary end points included the complication rate, technical success rate, and walking distance.


RESULTS
112 patients with a mean age of 72 years (41 women, 71 men) underwent crural angioplasty on 121 limbs. Four patients suffered from severe claudication (Rutherford category 3) and all others had critical chronic limb ischemia (category 4 to 6). The complication rate was 2.7 %. The technical success rate was 92 %. The ankle brachial index increased from 0.59 to 0.88. The mean walking distance increased significantly from 52 +/- 66 to 284 +/- 346 meters at the time of follow-up. The limb salvage rate was 83.6 % after one year and 81.1 % after three years. The mean survival rate according to Kaplan-Meier was 79.4 %, 69.2 %, and 54.2 % at 1, 2, and 3 years, respectively. Patients with at least one patent run-off vessel after angioplasty had a significantly better limb salvage rate. Diabetes was not a risk factor for limb salvage.


CONCLUSIONS
Infrapopliteal angioplasty shows a high technical success rate with an acceptable complication rate. The clinical long-term success seems favorable if a least one open run-off vessel was able to be achieved. However, the survival rate was limited by the co-morbidity in this patient group.
Alfke
H
H
Klinik für Diagnostische und Interventionelle Radiologie, Klinikum Lüdenscheid, Paulmannshöher Strasse 14, 58515 Lüdenscheid. heiko.alfke@klinikum-luedenscheid.de
Vannucchi
A
A
Froelich
J J
JJ
El-Sheik
M
M
Wagner
H-J
HJ
D000368:Aged; D000800:Angioplasty, Balloon / Q000401:mortality*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D007866:Leg / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome