Infra-inguinal percutaneous transluminal angioplasty for limb salvage:: A retrospective analysis in a single center

Purpose: To review the feasibility of infra-inguinal angioplasty in the management of critical limb ischemia (CLI). Material and Methods: Data on 221 patients with 230 critically ischemic limbs, treated with consecutive percutaneous transluminal angioplasty ( PTA) at Helsinki University Central Hospital between January 2000 and December 2002 were collected and analyzed retrospectively. Patency, limb salvage, and survival rates were calculated on an intention-to-treat basis. Comparisons were done with univariate (Kaplan-Meier) and multivariate analysis ( Cox regression). Results: Overall primary patency, secondary patency, limb salvage, and survival rates were 47%, 59%, 92%, and 76%, respectively, at 12 months. In the multivariate analysis, low toe pressure (<= 30 mmHg) was a significant risk factor for poor patency. Uremia with hemodialysis, low toe pressure (<= 30 mmHg), and hemodynamic failure of the endovascular procedure were found to increase significantly the risk of amputation. Uremia with hemodialysis, coronary artery disease, tissue loss as indication for PTA (Fontaine stage IV), and age over 70 years were all found to increase significantly the risk of death. Conclusion: Infra-inguinal PTA is feasible in patients with CLI and resulted in good limb salvage.