Critical limb ischemia (CLI) is a dangerous condition with a high mortality rate, potential socio-economic loss, and risk of amputation, especially in people with diabetes (1–4). Surgical bypass grafting has long been considered the gold standard of revascularization for lesions that are below the knee (BTK) (5). Percutaneous translumi- nal angioplasty (PTA) also improves limb perfusion; however, current treatment options are far from opti- mal even if this endovascular approach is the first-line option for patients with arterial occlusive disease above the inguinal ligament (6–8). In the past, there has been reluctance toward endo- vascular procedures performed BTK as studies have indicated limited treatment effect (9, 10). Primary patency of BTK angioplasty has shown inferior results at 1-year level compared to peripheral bypass surgery (58% vs 82%); however, the clinical benefit is compara- ble with equivalent limb salvage rates (11–13). The ultimate goal for treating BTK occlusive dis- ease is to
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This inclusion criterion was determined by an experienced vascular surgeon at the time of referral to PTA. The main reasons for not being a candidate for open sur- gery are listed in Table 1. In 50% of cases, more than one reason to not consider surgery was present (mean: 1.7; standard deviation (SD): 0.8; range: 1–4). Approval from the regional institutional review board was not required for the performed research. We identified 77 patients having 80 consecutive infrapopliteal endovascular procedures due to CLI from April 2010 through December 2012. Data were gathered prospectively from our in-house registry and were analyzed retrospectively. Six patients with prior in situ bypass graft were excluded due to in situ graft stenosis and not stenosis in the genuine artery, as well as one patient who was treated in the after- math of a trauma and had no history of PAD.
This inclusion criterion was determined by an experienced vascular surgeon at the time of referral to PTA. The main reasons for not being a candidate for open sur- gery are listed in Table 1. In 50% of cases, more than one reason to not consider surgery was present (mean: 1.7; standard deviation (SD): 0.8; range: 1–4). Approval from the regional institutional review board was not required for the performed research. We identified 77 patients having 80 consecutive infrapopliteal endovascular procedures due to CLI from April 2010 through December 2012. Data were gathered prospectively from our in-house registry and were analyzed retrospectively. Six patients with prior in situ bypass graft were excluded due to in situ graft stenosis and not stenosis in the genuine artery, as well as one patient who was treated in the after- math of a trauma and had no history of PAD.