The role of subintimal angioplasty in the management of arterial disease of the lower limb: the North-East of Scotland experience.
BACKGROUND
The management of occlusive femoropopliteal disease continues to evolve and a definitive strategy remains to be defined. We examine the utility ofsubintimal angioplasty (SIA) in our institution.


METHODS
A retrospective study with predefined end-points, including technical success and primary patency.


RESULTS
61 consecutive cases were identified (claudicants n=29 and critical ischaemia n=32). Sixty-four percent of occlusions were greater than 10 cm with poor run-off (60% with two vessels or less). Technical and physiological success was 95% and 79% respectively, with clinical improvement reported by 72%. At a mean follow-up of 20 months twelve-month primary patency (assessed clinically, with ABPI and selective duplex scanning) was 67% (subgroup analysis: claudicants 83%, criticals 53%, p=0.02) and morbidity 8% with no limb loss or procedure related mortality.


CONCLUSIONS
SIA is an effective procedure for chronic lower limb ischaemia with acceptable outcome. Our experience correlates well with evidence in the current literature.
Hussey
K K
KK
Department of Surgery, Aberdeen Royal Infirmary, UK. Keith.Hussey@doctors.org.uk
Hussey
J K
JK
Thorpe
P
P
Brittenden
J
J
Bachoo
P
P
D000368:Aged; D017130:Angioplasty; D005260:Female; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012606:Scotland; D016896:Treatment Outcome; D014654:Vascular Patency