Infrapopliteal Percutaneous Transluminal Angioplasty for Limb Salvage

Abstract

Purpose: To evaluate long-term results of infrapopliteal percutaneous translu-

Infra‐inguinal percutaneous transluminal angioplasty for limb salvage: a retrospective analysis in a single center

“…In conclusion, these results support the view that our changing approach towards considering PTA as first-line treatment for many patients with CLI seems justified; it has already been proposed by others (3,7,17,24,28,29). In addition, as noted in earlier reports (8,20), failure after attempted endovascular revascularization rarely compromises a subsequent surgical bypass option, which also advocates the primary use of endovascular techniques in cases of uncertainty.…”

“…In a study on the natural outcome of CLI, LEPÄ NTALO and MÄ TZKE (15) found that the limb salvage rate of unreconstructable CLI was 54% at 1 year. Accordingly, there are other studies reporting high limb salvage and clinical improvement rates, regardless of the patency rates (3,17,21,28). This indicates that in some cases the initial success of infra-inguinal PTA could be sufficient for a favorable outcome in CLI patients.…”

“…Recent papers reporting on the results of infrainguinal angioplasty in the treatment of CLI patients show excellent limb salvage rates of up to 91% at 5 years (3,7,11,13,24). There are even centers with a policy to treat the majority of patients with CLI with (subintimal) angioplasty based on their understanding that the results could be superior to surgery (23,29).…”

Vibrational Angioplasty in the Treatment of Chronic Infrapopliteal Arterial Occlusions: Preliminary Experience

“…9,18 The reported limb salvage rates using infrapopliteal PTA are 77% to 89% up to 36 months, 2,7,8,[18][19][20][21][22][23][24] which compares well to femorocrural bypass surgery (78% with in situ grafts and 87% with reversed ones for up to 3 years). 25 The low morbidity and mortality of infrapopliteal PTA makes it a reasonable firstline therapy for patients suffering from chronic limb ischemia who are high-risk candidates for surgery.…”

Vessel size estimation in peripheral artery interventions: are angiographic measurements reliable?

“…Although it is well known that mismatch of balloon and stent to vessel size is a common cause of early and late failure, the measuring of vessel size is often not described. In one article on long-term results after infrapopliteal PTA, in some cases in association with PTA of the SFA or the popliteal artery, measurement of vessel size is not even mentioned (5). In some instances, the procedures are clearly not based on any measurement at all: a standard size balloon is used for specific locations (4,16,17,24).…”