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Indications and clinical outcomes for below knee endovascular therapy: review article

Lanfroi Graziani1, Alberto Piaggesi

  • 1Invasive Cardiology Unit, Istituto Clinico Città di Brescia, Brescia, Italy. lanfroi.graziani@grupposandonato.it

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|November 26, 2009
PubMed

Insights

Peripheral revascularization for critical limb ischemia (CLI) is vital. Below-knee (BK) endovascular therapy can reduce amputations and mortality, despite high restenosis rates, especially in diabetic patients.

Area of Science:

  • Vascular Surgery
  • Endovascular Interventions
  • Diabetology

Background:

  • Chronic critical limb ischemia (CLI) is a leading cause of amputation.
  • Below-knee (BK) artery revascularization is often under-evaluated before amputation.
  • Diabetic foot syndrome presents unique challenges in CLI management.

Purpose of the Study:

  • To review indications and clinical outcomes of BK endovascular therapy.
  • To highlight the impact of diabetes mellitus on CLI treatment.
  • To clarify the role and effectiveness of endovascular treatment in BK arteries.

Main Methods:

  • Review of existing literature on BK endovascular therapy for CLI.
  • Analysis of clinical outcomes, including patency, limb salvage, and mortality.
  • Focus on the specific characteristics and outcomes in diabetic patients.

Main Results:

  • BK endovascular therapy can reduce major amputation rates and mortality.
  • High rates of restenosis are observed, while ulcer healing and limb salvage rates are often low.
  • Clinical benefit may not directly correlate with primary patency rates.

Conclusions:

  • Despite challenges like high restenosis, BK endovascular therapy positively impacts CLI outcomes.
  • Revascularization is crucial for reducing mortality in CLI patients, particularly through amputation reduction.
  • Understanding the role of diabetes is essential for optimizing BK endovascular therapy.

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