title: The Feasibility of Angiosome-Targeted Endovascular Treatment in Patients with Critical Limb Ischemia and Foot Ulcer.
abstract: BACKGROUND
  To determine wound location according to the angiosome concept and to investigate the feasibility and success of angiosome-based revascularization in below-the-knee (BTK) arteries.
  
  
  METHODS
  This was a retrospective study of 161 patients (67.5 ± 25.5 years, 66.5% diabetics) with critical limb ischemia and a foot ulcer, stage Rutherford 5-6, who underwent percutaneous transluminal angioplasty on BTK arteries in 2012. We evaluated feasibility of angiosome-targeted revascularization and the number of angiosomes affected by a wound in each patient. Patients were divided into 3 groups depending on how many BTK vessels were suitable for revascularization. The feasibility was analyzed in each group and in relation to number of affected angiosomes.
  
  
  RESULTS
  The wound(s) interfered with one angiosome in only 39 (24.0%) cases. Direct flow into affected angiosome was successfully achieved in 98 (60.9%) cases. If ulceration was limited in one angiosome, the targeted revascularisation was possible in 27 cases (69.2%), if ulceration was extended over 2 angiosomes it was possible in 65 cases (86.7%), if 3 angiosomes were affected it was possible in 36 cases (85.7%), when 4 angiosomes were affected the rate dropped to 25.0% and ulceration extended over 5 angiosomes had no possibility of revascularization.
  
  
  CONCLUSIONS
  In critical limb ischemia, the tissue lesion affects several angiosomes in majority of the cases. In thus far published literature, there is existence of more approaches of angiosome-targeted revascularization when more than one angiosome is clinically involved and therefore consensus needs to be achieved for the accurate definition.
authors.affiliation: Department of Vascular Surgery, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. Electronic address: kspillerova@gmail.com.
authors.forename: Kristýna
authors.initials: K
authors.lastname: Špillerová
authors.affiliation: Department of Vascular Surgery, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Maria
authors.initials: M
authors.lastname: Sörderström
authors.affiliation: Department of Vascular Surgery, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Anders
authors.initials: A
authors.lastname: Albäck
authors.affiliation: Department of Vascular Surgery, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Maarit
authors.initials: M
authors.lastname: Venermo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D057510:Endovascular Procedures; D005240:Feasibility Studies; D016523:Foot Ulcer / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000601:surgery*; D035002:Lower Extremity / Q000098:blood supply*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome