title: Determinants of intermediate term clinical outcome after endovascular below-knee interventions.
abstract: BACKGROUND
  To determine predictors of clinical outcome after endovascular interventions of crural arteries in patients with peripheral arterial disease.
  
  
  METHODS
  We prospectively followed 154 limbs in 147 patients treated with below the knee endovascular interventions for critical limb ischemia (52 %) and severe claudication (48 %). Patient-immanent, hemodynamic-procedural and anatomic determinants of outcome were analyzed. Outcome was defined as event-free survival from the combined endpoint freedom from re-intervention, major amputation and death.
  
  
  RESULTS
  Cumulative event-free survival after 12 months was 65.1 %. During follow-up 42 patients (27.3 %) required re-intervention, 8 (5.2 %) underwent major amputation and 5 (3.2 %) died. In univariate analyses, the presence of critical limb ischemia, multilevel disease, age > 72 years, impaired renal function, and long lesions (> 65 mm) were significant determinants of the study endpoint. The anatomic location of the lesion, distal patency of treated artery below the ankle, cardiovascular risk factors or concomitant cardiovascular diseases, and the type of postinterventional antithrombotic treatment did not influence outcome.
  
  
  CONCLUSIONS
  Below-knee interventions resulted in acceptable procedural mid-term results and high rates of amputation free survival. Multilevel disease, long lesions and impaired renal function were indicative of a worse outcome.
authors.affiliation: Department of Medicine III, University Hospital Carl Gustav Carus Dresden, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Köhler
authors.forename: K
authors.initials: K
authors.lastname: Halbritter
authors.forename: C
authors.initials: C
authors.lastname: Stroszczynski
authors.forename: A
authors.initials: A
authors.lastname: Mahlmann
authors.forename: J
authors.initials: J
authors.lastname: Beyer-Westendorf
authors.forename: N
authors.initials: N
authors.lastname: Weiss
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D016009:Chi-Square Distribution; D016638:Critical Illness; D018572:Disease-Free Survival; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006439:Hemodynamics; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy; D007511:Ischemia / Q000209:etiology / Q000628:therapy; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome