Value of cutting balloon angioplasty for limb salvage in patients with obstruction of popliteal and distal arteries.
Popliteal-to-distal bypass is still the gold standard for limb salvage. However, some patients, especially elderly or diabetic patients, are not eligible for such treatment; and problems may arise, including poor healing of distal surgical wounds, delayed resumption of ambulation, and prolonged hospitalization. This prospective multicenter study carried out on an intent-to-treat basis includes 53 extremities in 48 patients presenting critical ischemia due to infrageniculate arterial lesions with no proximal lesions. Two populations were isolated: diabetic patients (56.6%) and elderly patients over 80 years (45%). In 82% of cases the arterial lesions were long, i.e., more than 1 cm. The limb salvage rate at 1 year was 81%. Postoperative mortality was 9%, and mortality at 1 year was 22.6%. These results show that cutting balloon angioplasty can be proposed as primary treatment in patients with critical ischemia due to popliteal and distal artery lesions.
Cardon
Jean-Marie
JM
Hôpital Privé Les Franciscaines, Nîmes, France. vascu.cardon@wanadoo.fr
Jan
François
F
Vasseur
Marc-Antoine
MA
Ferdani
Michel
M
Rind
Alain
A
François
Fabrice
F
Cardon
Alain
A
D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000401:mortality / Q000628:therapy*; D003251:Constriction, Pathologic; D016638:Critical Illness; D048909:Diabetes Complications / Q000401:mortality / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D005602:France; D006801:Humans; D007511:Ischemia / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome