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Tibial angioplasty in diabetic patients: should all vessels be treated?

A Sayed1, A Taha, M Elkholy

  • 1Vascular Surgery Unit, Kasr Alaini Hospital, Cairo University, Cairo, Egypt. ahmed.sayed@kasralainy.edu.eg

International Angiology : a Journal of the International Union of Angiology
|May 29, 2012
PubMed

Insights

Treating one or more tibial vessels in patients with critical limb ischemia (CLI) yields similar limb salvage rates. Angioplasty of multiple tibial vessels is safe and effective, even with complex lesions.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Diabetic Limb Complications

Background:

  • Critical limb ischemia (CLI) due to tibial disease is often treated with angioplasty.
  • The comparative outcomes of treating single versus multiple tibial vessels in CLI patients remain unclear.

Purpose of the Study:

  • To compare the outcomes of angioplasty in patients with CLI due to tibial disease, focusing on single-vessel versus multi-vessel treatment.
  • To evaluate limb salvage rates and complications associated with these different angioplasty approaches.

Main Methods:

  • Retrospective review of 48 diabetic patients with isolated tibial disease undergoing angioplasty.
  • Patients were divided into two groups: single tibial vessel treated (Group A, N.=25) and multiple tibial vessels treated (Group B, N.=23).
  • Comparison of patient characteristics, lesion morphology, and limb salvage rates at 12 months.

Main Results:

  • Group A (single vessel) presented with worse lesion morphology, including longer lesions and more occlusions in the anterior tibial and peroneal arteries.
  • Limb salvage rates at 12 months were similar between Group A (91%) and Group B (91%).
  • Complication rates were comparable, with 5 complications in each group.

Conclusions:

  • Despite more complex lesions in the single-vessel group, angioplasty outcomes are similar whether one or multiple tibial vessels are treated.
  • Treating multiple tibial vessels in CLI patients is not associated with increased morbidity.
  • Angioplasty of additional tibial vessels in less diseased arteries offers comparable limb salvage rates in the medium term.
Abstract

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