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Percutaneous angioplasty of long tibial occlusions in critical limb ischemia

Nirvana Sadaghianloo1, Elixène Jean-Baptiste, Serge Declemy

  • 1Department of Vascular Surgery, University Hospital of Nice, Nice, France.

Annals of Vascular Surgery
|September 3, 2013
PubMed

Insights

Percutaneous angioplasty for long tibial occlusions shows a 65% midterm success rate in improving wound healing for critical limb ischemia patients. Maximal revascularization approaches enhance outcomes, despite technical challenges.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Therapy

Background:

  • Critical limb ischemia (CLI) poses a significant challenge, particularly with long tibial occlusions.
  • Percutaneous angioplasty is a potential treatment modality for limb salvage in these patients.

Purpose of the Study:

  • To evaluate the midterm clinical outcomes of percutaneous angioplasty in patients with CLI and long tibial occlusions.
  • To assess factors influencing clinical success, patency, and revascularization rates.

Main Methods:

  • A prospective, single-center cohort study included 34 patients with 49 long tibial occlusions (>8 cm).
  • Clinical success was defined as wound healing and survival without major amputation.
  • Key outcomes examined included patency and freedom from target vessel revascularization (TVR).

Main Results:

  • The 1-year clinical success rate was 65%, significantly higher with technical success (76%) and multiple patent tibial arteries (90%).
  • Primary and secondary patency rates at 1 year were 13% and 32% respectively (24% and 58% excluding technical failures).
  • The 1-year freedom-from-TVR rate was 34%.

Conclusions:

  • Percutaneous angioplasty for long tibial occlusions can improve wound healing in CLI patients.
  • Maximal revascularization strategies are crucial for enhancing outcomes.
  • High technical failure rates necessitate repeat procedures but do not negate the benefits of angioplasty.
Abstract

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