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Outcome of Redo Endovascular Interventions in Cases of Infra-inguinal Arterial Occlusive Disease

Khaled Mohamed Fekry1, Sherif Balbaa1, Ahmed Saeed1

  • 1Department of Vascular Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.

The International Journal of Angiology : Official Publication of the International College of Angiology, Inc
|August 7, 2025
PubMed

Insights

Drug-coated balloons (DCB) and stenting improve blood flow and limb salvage in chronic limb-threatening ischemia (CLTI) patients compared to plain old balloon angioplasty (POBA). DCB excels in wound healing, while both DCB and stenting reduce amputations.

Area of Science:

  • Vascular Surgery
  • Endovascular Interventions
  • Peripheral Artery Disease

Background:

  • Chronic limb-threatening ischemia (CLTI) poses a significant risk for amputation.
  • Redo endovascular interventions are crucial for managing recurrent or persistent peripheral artery disease.
  • Comparative outcomes of different redo endovascular techniques are not fully elucidated.

Purpose of the Study:

  • To evaluate the efficacy of stenting, drug-coated balloon (DCB) angioplasty, and plain old balloon angioplasty (POBA) in redo endovascular interventions for CLTI.
  • To compare wound healing and limb salvage rates at 6 months post-intervention.
  • To assess technical success and amputation-free survival across different treatment modalities.

Main Methods:

  • Prospective clinical study involving 56 patients with CLTI.
  • Patients underwent redo peripheral endovascular intervention 6 months to 1 year after a previous procedure.
  • Interventions included stenting, DCB angioplasty, and POBA; outcomes were assessed at 6 months.

Main Results:

  • Stenting and DCB showed higher technical success in restoring linear blood flow (CFA to foot) than POBA (p=0.032, p=0.033).
  • DCB demonstrated superior wound healing at 3 months compared to POBA and stenting (p=0.002, p=0.007).
  • Amputation-free survival was better with stenting and DCB versus POBA (p=0.016, p=0.018), with no significant difference between stenting and DCB.

Conclusions:

  • Stenting and DCB angioplasty are superior to POBA for restoring arterial patency and improving amputation-free survival in redo interventions for CLTI.
  • DCB angioplasty offers advantages in wound healing compared to stenting and POBA.
  • These findings support the use of DCB and stenting for better limb salvage outcomes in complex peripheral artery disease cases.

Keywords:
CLTIDCBPOPAangioplastyendovascularinfra-inguinalredo

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