Related Experiment Video

Updated: Aug 15, 2025

Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
07:25

Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia

Published on: September 22, 2020

3.5K

FEMOROPOPLITEAL ANGIOPLASTY VS OPEN SURGERY FOR CHRONIC LIMB-THREATENING ISCHEMIA

Oleksandr A Holyachenko1, Anatolii M Kravchenko1, Andrii O Golyachenko2

  • 1STATE INSTITUTION OF SCIENCE «RESEARCH AND PRACTICAL CENTER OF PREVENTIVE AND CLINICAL MEDICINE» STATE ADMINISTRATIVE DEPARTMENT, KYIV, UKRAINE.

Wiadomosci Lekarskie (Warsaw, Poland : 1960)
|January 2, 2023
PubMed

Insights

Femoro-popliteal percutaneous transluminal angioplasty (PTA) and open surgery offer comparable limb salvage rates for chronic limb-threatening ischemia (CLTI). Long-term results show no significant difference in limb preservation or amputation between these revascularization methods.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Interventions

Background:

  • Chronic limb-threatening ischemia (CLTI) presents a significant challenge in vascular care, often requiring complex revascularization strategies.
  • Femoro-popliteal arterial segment steno-occlusive lesions (SOL) are a common cause of CLTI, necessitating effective treatment to prevent amputation.
  • Comparing open surgical repair with endovascular techniques like percutaneous transluminal angioplasty (PTA) is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To compare the efficacy of femoro-popliteal percutaneous transluminal angioplasty (PTA) versus open surgery in patients with chronic limb-threatening ischemia (CLTI).
  • To analyze the long-term clinical outcomes, including limb salvage and survival rates, for different revascularization methods in CLTI.
  • To evaluate the impact of comorbidities, such as diabetes, on the outcomes of femoro-popliteal revascularization.

Main Methods:

  • A retrospective study involving 145 patients with CLTI undergoing unilateral femoro-popliteal revascularization between 2018 and 2019.
  • Patients were divided into three groups: open surgery (48 patients), percutaneous transluminal angioplasty (PTA) (73 patients), and hybrid surgical interventions (24 patients).
  • Outcomes assessed included 2-year limb preservation, amputation rates, and the need for re-intervention, with statistical analysis to compare group differences.

Main Results:

  • No statistically significant difference in overall patient indicators was observed among the three treatment groups.
  • Diabetes prevalence varied significantly across groups (16.7% open surgery, 45.8% PTA, 54.8% hybrid; p<0.001).
  • Two-year limb preservation rates were high and comparable: 93.8% (open surgery), 91.7% (PTA), and 91.6% (hybrid). Amputation rates were 6.2%, 8.2%, and 8.3%, respectively. Re-intervention rates differed between hybrid surgery and the other two groups.

Conclusions:

  • Limb salvage and survival rates for CLTI patients treated with open surgery or PTA were comparable at the 2-year follow-up.
  • The choice of revascularization method (open surgery, PTA, or hybrid) did not significantly impact limb preservation or amputation rates in the long term.
  • While overall outcomes were similar, differences in re-intervention tactics were noted, particularly concerning hybrid interventions.
Abstract

Keywords:
duplex ultrasound scanpercutaneous transluminal angioplasty (PTA)steno-occlusive lesions

More Related Videos

High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model08:16

High-Resolution Three-Dimensional Imaging of the Footpad Vasculature in a Murine Hindlimb Gangrene Model

Published on: March 16, 2022

3.6K
Minimally Invasive Isolated Limb Perfusion (MI-ILP) for Locally Advanced Melanomas and Sarcomas of the Extremity09:38

Minimally Invasive Isolated Limb Perfusion (MI-ILP) for Locally Advanced Melanomas and Sarcomas of the Extremity

Published on: January 31, 2025

532

Related Concept Videos

Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
18
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
17
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
17
Varicose Veins II: Diagnostic Studies and Interprofessional Care01:26

Varicose Veins II: Diagnostic Studies and Interprofessional Care

Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
22
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
24