title: A retrospective analysis of laser endartherectomy assisted balloon angioplasty for popliteal and infrapopliteal peripheral arterial disease.
abstract: OBJECTIVE
  To describe our single center experience with the use of laser endartherectomy assisted balloon angioplasty in popliteal and infrapopliteal arterial disease.
  
  
  BACKGROUND
  Peripheral arterial disease (PAD) carries significant morbidity to patients. Some patients may have multiple comorbid conditions potentially limiting therapeutic options for PAD. Endovascular interventions are aimed at decreasing arterial disease symptoms, improve wound healing and ultimately limb salvage. There is limited data on below the knee PAD and simultaneous laser endartherectomy use in this anatomic location.
  
  
  METHODS
  The cohort comprised 41 patients that underwent laser assisted balloon angioplasty from 2010 to 2013. All patients had popliteal and infrapopliteal arterial disease. Outcomes evaluated were limb salvage and symptom relief 12months following the procedure. A comparison between the patients that underwent amputation and those with limb salvage was also performed.
  
  
  RESULTS
  All the patients had TASC II (Trans Atlantic Inter-Society Consensus) type D lesions. Most patients reported persistent PAD symptoms by six months, with 17% remaining symptom free by 12months. Affected limb salvage was 69%. Five patients (12%) died and one third of the patients had a new peripheral angiogram. In the repeat angiogram, most patients showed initial target vessel occlusion. No statistically significant differences were found between the patients that preserved their limb to those who underwent amputation.
  
  
  CONCLUSIONS
  Laser assisted balloon angioplasty use for complex popliteal and infrapopliteal arterial disease is a therapeutic option when limb salvage is the goal. Despite this, symptom recurrence and the need for repeated angiography continue to be high.
authors.affiliation: Department of Cardiovascular Diseases, Texas Tech University Health Sciences Center, Lubbock, TX, United States. Electronic address: erwin.argueta@ttuhsc.edu.
authors.forename: Erwin E
authors.initials: EE
authors.lastname: Argueta
authors.affiliation: Department of Cardiovascular Diseases, Texas Tech University Health Sciences Center, Lubbock, TX, United States.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Rosales
authors.affiliation: Department of Cardiovascular Diseases, Texas Tech University Health Sciences Center, Lubbock, TX, United States.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Suarez
mesh_terms: D000368:Aged; D017222:Angioplasty, Balloon, Laser-Assisted / Q000379:methods / Q000401:mortality / Q000639:trends*; D015331:Cohort Studies; D004691:Endarterectomy / Q000379:methods / Q000401:mortality / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D023821:Limb Salvage / Q000401:mortality / Q000639:trends*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D058729:Peripheral Arterial Disease / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D011150:Popliteal Artery / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology
keywords: Critical limb ischemia; Laser; Peripheral arterial disease