THE RELATIONSHIP BETWEEN THE LENGTH OF OCCLUSION IN INFRAINGUINAL VESSELS IN CRITICAL LOWER LIMB ISCHAEMIA AND THE OUTCOME AFTER ENDOVASCULAR INTERVENTION

Document Type : Original Article

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Department of General Surgery, Faculty of Medicine Cairo University, Egypt

Abstract

Critical limb ischemia (CLI) represents the most severe clinical manifestation of peripheral arterial disease. Patients suffering from CLI have traditionally been treated with surgical bypass to avoid major amputation. However, there are increasing data on the efficacy of endovascular revascularization procedures in achieving good leg salvage rate. The current study was designed to deal with 80 cases presented with critical lower limb ischemia involving the femoro-popliteal and infrapopliteal arteries. This study aims at reviewing the demographic features of patients presenting with CLI and reviewing the relation between the length of occlusion and clinical outcome after endovascular intervention, as regards the technical success rate and the short term follow up (patency rate and limb salvage rate). Patients were classified according to TASC II classification into TASC B (22.5%), TASC C (22.5%) and TASC D (55%). According to the length of the lesion <5 cm (17.5%), 5-10 cm (45%) and >10 cm (37.5%).All patients were offered a trial of revascularization by endovascular technique. Technical success was 97.5%. At 3, 6 and 12 months follow-up periods; overall Primary patency rates were 90%, 80% &72% respectively, Secondary patency rates were 95%, 91% &85% respectively, and Limb salvage rates were 92.5%, 87.5% and 83.75% respectively. Major amputation rate was 16.25%. It was concluded that, the length of the lesion, the multilevel disease and the single vessel runoff after angioplasty, all had their effect on the patency rates and the limb salvage rate. 
The Egyptian Journal of Surgery
Volume 32, Issue 2
April 2013
Pages 138-144

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