[A clinical study of infrapopliteal balloon angioplasty for patients with critical lower limb ischemia].
OBJECTIVE
To evaluate the efficacy of infrapopliteal angioplasty as the first-choice procedure in patients with critical lower limb ischemia.


METHODS
From December 2005 to May 2009, infrapopliteal angioplasty was considered as the first-choice method in consecutive patients with infrapopliteal occlusive disease hospitalized for critical ischemia. Fifty-four patients (61 limbs) with a mean age of 66 years old (37 male and 17 female) underwent infrapopliteal balloon angioplasty. The preoperative ankle branchial index (ABI) was 0.43 + or - 0.27.


RESULTS
Iliofemoral artery revascularization (stenting in 28 limbs and bypass in 5 limbs) were successful. Infrapopliteal balloon dilation was success in 57 limbs, the technical success rate was 93.4%. The major complications were calf hematoma in 3 cases (4.9%), and below-the-knee amputation in 2 cases (3.3%). Postoperative ABI increased to 0.86 + or - 0.21(P < 0.01). Mean follow-up time was (16 + or - 11) months. The primary patency rate was 61.1%, restenosis rate was 38.9% (21 of 54 limbs), and surgical intervention were performed for 10 limbs, the secondary patency rates was 75.9%. Major amputation in 3 limbs during follow-up period, the limb salvage rate was 91.8%.


CONCLUSIONS
Infrapopliteal balloon angioplasty as the first-choice method is feasible, safe and effective for limb salvage in patients with critical lower limb ischemia.
Liu
Chang-wei
CW
Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China. liucw@vip.sina.com
Shao
Jiang
J
Liu
Bao
B
Ye
Wei
W
Zeng
Rong
R
Wu
Wei-wei
WW
Chen
Yue-xin
YX
Song
Xiao-jun
XJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome