[Effectiveness of endovascular therapy for critical limb ischemia]

The objective of this study was to clarify the results of endovascular therapy (EVT) for critical limb ischemia (CLI). EVT is an emerging new technique for the revascularization of lower-limb ischemia. EVT is used in cases of iliac artery lesions but can also be used in femoropopliteal and below-the-knee lesions in patients with CLI. From May 1998 to June 2008, 150 limbs in 122 consecutive patients with CLI were treated using EVT and followed up to evaluate the initial success. Late follow-up status was then evaluated with the Kaplan-Meier method. Angiographic success was achieved in 134 patients (92%). There were 3 deaths related to EVT. Limb salvage rates at 1, 2, and 5 years were 92%, 86%, and 86%, respectively. Survival rates at 1, 2, and 5 years were 82%, 61%, and 56%, respectively. Patients in the hemodialysis group had a significantly worse prognosis than those in other groups. Based on our results, EVT is a feasible, safe, effective procedure for the treatment of CLI. High limb salvage rates were achieved with EVT, and it can be the primary choice for revascularization of CLI in infrapopliteal artery disease.