title: Amputation-Free Survival after Crural Percutaneous Transluminal Angioplasty for Critical Limb Ischemia.
abstract: OBJECTIVE
  To evaluate the amputation-free survival after below the knee percutaneous transluminal angioplasty in a consecutive group of patients with critical ischemia of the lower extremity.
  
  
  METHODS
  A total of 70 consecutive patients with critical ischemia were treated with below the knee percutaneous transluminal angioplasty at the vascular center at Rigshospitalet with the purpose of limb salvage. All patients were deemed unfit for major surgery due to anatomical limitations or severe co-morbidity, and no prior attempts of revascularization were performed. Follow-up clinical examinations were performed within 6 weeks and after 1 year. All medical records were crosschecked with the national vascular registry ensuring a valid 1-year status in 97% of the patients.
  
  
  RESULTS
  A total of 15 major amputations were performed during follow-up, with 11 amputations performed within the first year. Complications after percutaneous transluminal angioplasty were rare. Cumulative mortality after 1 and 2 years was 22% and 34%, respectively. Amputation-free survival at 1 and 2 years of follow-up was 68% and 58%, respectively. There were no association between known risk factors such as diabetes, ischemic ulcers, cardiac disease, history of smoking, major amputation, or overall amputation.
  
  
  CONCLUSIONS
  Below the knee percutaneous transluminal angioplasty in patients with end-stage peripheral arterial disease and critical limb ischemia is a safe procedure in relieving critical ischemia, reducing the short-term rate of a major amputation as opposed to best medical treatment alone.
authors: Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark Centre for Clinical Education, The Capital Region of Denmark, Copenhagen, Denmark michael.stroem@regionh.dk.
authors: M
authors: M
authors: Strøm
authors: Centre for Clinical Education, The Capital Region of Denmark, Copenhagen, Denmark University of Copenhagen, Copenhagen, Denmark.
authors: L
authors: L
authors: Konge
authors: Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark University of Copenhagen, Copenhagen, Denmark Department of Radiology, Rigshospitalet, Copenhagen, Denmark.
authors: L
authors: L
authors: Lönn
authors: Centre for Clinical Education, The Capital Region of Denmark, Copenhagen, Denmark University of Copenhagen, Copenhagen, Denmark.
authors: T V
authors: TV
authors: Schroeder
authors: Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark.
authors: P
authors: P
authors: Rørdam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D017130:Angioplasty / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D007866:Leg / Q000098:blood supply* / Q000601:surgery; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Critical limb ischemia; amputation; angioplasty; infrapopliteal lesions; survival