title: Midterm outcomes and risk stratification after endovascular therapy for patients with critical limb ischaemia due to isolated below-the-knee lesions.
abstract: OBJECTIVE
  To assess and risk stratify midterm clinical outcomes after endovascular therapy (EVT) by angioplasty only of patients with critical limb ischaemia (CLI) due to isolated below-the-knee (BTK) lesions.
  
  
  METHODS
  Retrospective multicenter study.
  
  
  METHODS
  Between March 2004 and October 2010, 465 limbs (Rutherford 5 and 6: 79%) from 406 patients were studied. Overall survival, limb salvage, and re-intervention were examined out to 3 years by the Kaplan-Meier method and the log-rank test. Their independent predictors and risk stratification were analysed.
  
  
  RESULTS
  Patient age was 71 ± 11 yrs, with 69% diabetics and 60% on dialysis. Mean follow-up was 18 ± 15 months. Overall survival was 76 ± 2 and 57 ± 4% at 1 and 3, years, respectively. Survival predictors were body mass index <18, non-ambulatory status and ejection fraction <45%. Two-year limb salvage rate was 80 ± 2%. Factors associated with major amputation were ulcers (Rutherford 6), diabetes mellitus, C-reactive protein>5 mg/dL, and age < 60 years. Two-year freedom from re-intervention was 66 ± 3%; age and below-the-ankle runoff number after angioplasty was negatively associated with re-intervention.
  
  
  CONCLUSIONS
  Despite relatively high mortality and re-intervention rates, limb salvage rate was acceptable after EVT for CLI patients with isolated BTK lesions. Risk stratification allows occurrence estimation for each end point.
authors.affiliation: Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, Japan. iida.osa@gmail.com
authors.forename: O
authors.initials: O
authors.lastname: Iida
authors.forename: Y
authors.initials: Y
authors.lastname: Soga
authors.forename: K
authors.initials: K
authors.lastname: Hirano
authors.forename: D
authors.initials: D
authors.lastname: Kawasaki
authors.forename: K
authors.initials: K
authors.lastname: Suzuki
authors.forename: Y
authors.initials: Y
authors.lastname: Miyashita
authors.forename: S
authors.initials: S
authors.lastname: Nanto
authors.forename: M
authors.initials: M
authors.lastname: Uematsu
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D000800:Angioplasty, Balloon; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002423:Cause of Death; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007511:Ischemia / Q000401:mortality / Q000601:surgery*; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D007866:Leg / Q000098:blood supply* / Q000601:surgery*; D023821:Limb Salvage / Q000379:methods* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D015996:Survival Rate; D016896:Treatment Outcome