Percutaneous transluminal angioplasty in critical limb ischaemia

To determine the utility of percutaneous transluminal angioplasty (PTA) in the treatment of chronic critical lower-limb ischaemia, a prospective study of 103 consecutive patients (117 limbs) was performed. A total of 209 lesions were treated in the iliac (n = 4), femoropopliteal (n = 121), and intrapopliteal (n = 84) arteries. The follow-up time was 1-36 months (mean 12 months). The technical success rate was 92% for stenosis and 80% for occlusion. The cumulative limb salvage rate was 56% at one year, 49% at two years and 49% at three years. The following factors correlated favourably with limb salvage in Cox multiple regression analyses: a small number of diseased lower-limb vessels (one to five vs six to eight) and treated lesions per limb (one to two vs three to five), peripheral runoff after PTA (at least one patent calf vessel vs none) and an occlusion as the successfully treated lesion (instead of stenosis).