Reconstructive options for critical limb ischaemia in infrapopliteal arteries
10.3760/cma.j.issn.1007-631X.2011.03.006
- VernacularTitle:腘以远动脉闭塞所致下肢严重缺血的血供重建
- Author:
Xinwu LU
;
Kaichuang YE
;
Weimin LI
;
Ying HUANG
;
Min LU
;
Xintian HUANG
;
Xiaobing LIU
;
Minyi YIN
;
Huihua SHI
;
Mier JIANG
- Publication Type:Journal Article
- Keywords:
Arterial occlusive diseases;
Angioplasty;
Bypass,lower extremity
- From:
Chinese Journal of General Surgery
2011;26(3):192-194
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess reconstructive options for critical limb ischaemia in infrapopliteal arteries. Methods A retrospective review of all CLI patients who underwent infrapopliteal reconstruction was carried out. Patient history, demographics, procedure details, complications, and follow-up information were collected and analyzed. Patency, limb salvage rate was determined by Kaplan-Meier analysis. Results During the period (from December 2003 to January 2008 ), 123 CLI patients with arteriosclerosis occlusions were treated on an intention-to-treat basis with infrapopliteal percutaneous transluminal angioplasty (PTA).Thirty-three thromboangiitis obliterans and twenty-three arteriosclerosis occlusions suffering CLI were treated by infrapopliteal bypass procedures. Primary patency and limb salvage rate of infrapopliteal PTA at 6, 12 and 24 months was 67%, 54%, 49% and 91%, 85%, 78% respectively, Primary patency and limb salvage rate of infrapopliteal surgical bypass at 6, 12 and 24 months was 90%, 83%, 79% and 92%,87%, 80% respectively, the patency of infrapopliteal PTA was lower than infrapopliteal surgical bypass (P ＜0. 01 ), but the limb salvage rate of infrapopliteal PTA and open surgery was no significant difference (P ＞ 0. 05 ). Conclusion Endovascular treatment (PTA) in patients with infrapopliteal arteriosclerosis occlusions and critical ischaemia is safe, effective. Infrapopliteal PTA can be used as the choice of therapy and surgical bypass reserved in those endovascular treatment failed. While in CLI patients with thromboangiitis obliterans infrapopliteal artery bypass remains the best treatment option.
