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Assessing Therapeutic Angiogenesis in a Murine Model of Hindlimb Ischemia
07:48

Assessing Therapeutic Angiogenesis in a Murine Model of Hindlimb Ischemia

Published on: June 8, 2019

Comparison of results in endovascular interventions for infrainguinal lesions: claudication versus critical limb

Susan M Trocciola1, Rabih Chaer, Rajeev Dayal

  • 1Division of Vascular Surgery, New York Presbyterian Hospital, Cornell University, New York, New York 10021, USA.

The American Surgeon
|July 28, 2005
PubMed

Insights

Endovascular repair shows acceptable 12-month patency for chronic limb ischemia (CLI) patients, including those with claudication and critical limb ischemia. This minimally invasive approach offers limited morbidity for infrainguinal arterial disease treatment.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Therapies

Background:

  • Chronic limb ischemia (CLI) encompasses both claudication and critical limb ischemia (CLI), necessitating effective treatment strategies.
  • Endovascular repair offers a minimally invasive option for infrainguinal arterial disease.
  • Comparing outcomes between claudicants and critical limb ischemia patients is crucial for treatment optimization.

Purpose of the Study:

  • To analyze clinical success, patency, and limb salvage after endovascular repair in patients with CLI.
  • To compare outcomes between patients presenting with claudication versus critical limb ischemia.
  • To evaluate the efficacy of percutaneous techniques for infrainguinal arterial disease.

Main Methods:

  • Retrospective analysis of 115 patients (mean age 71) undergoing endovascular treatment for infrainguinal arterial disease (Oct 2001-Aug 2004).
  • Techniques included subintimal angioplasty and transluminal angioplasty with or without stents, classified by Transatlantic InterSociety Consensus criteria.
  • Follow-up included physical exam, ankle-brachial index, and duplex ultrasound; patency assessed by Kaplan-Meier and log-rank analysis.

Main Results:

  • 199 lesions treated in 121 limbs using percutaneous techniques.
  • Higher rates of diabetes mellitus (67% vs 41%) and chronic renal insufficiency (22% vs 7%) in critical limb ischemia patients.
  • 12-month primary patency: 85% for claudicants vs 72% for critical limb ischemia (P=0.06).
  • 12-month limb salvage: 91% for critical limb ischemia patients.
  • Similar morbidity and no perioperative mortality between groups.

Conclusions:

  • Percutaneous endovascular intervention provides acceptable 12-month patency for both claudication and critical limb ischemia.
  • The procedure demonstrates limited morbidity, making it a viable option for infrainguinal arterial disease.
  • Further research may explore long-term outcomes and patient selection for optimal results.

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