Outcome of Tibial Angioplasty Versus Multilevel Angioplasty at Critical Limb Ischemia of The Lower Limb

Document Type : Original Article

Authors

1 General and Vascular Surgery Department, Suez Canal Authority Hospital, Ministry of Health, Egypt

2 Department of General and Vascular Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

Abstract

Background: A severe type of peripheral artery disease, critical limb ischemia is characterized by ulceration or gangrene
of the foot or toes, as well as chronic, recurrent ischemic rest discomfort that requires analgesia for at least 2 weeks.
Comparing the main patency, limb salvage, and major amputation rates between isolated tibial disease and the multilayer
disease at the peripheral artery disease was the goal of this study.
Patients and Methods: A total of 42 patients with lower limb ischemia, both sexes, ages 40–77, participated in this
prospective intervention trial. Patients were split into two equal groups: group B had multilevel disease (tibial disease with
proximal popliteal and/or femoral artery disease), and group A had isolated tibial disease.
Results: Hyperlipidemia was significantly different between the groups (P= 0.043). More than one artery, primary
patency rate at sixth month, major amputation, healing, and limb salvage were significantly different between the groups
(P<0.05). There was pseudo aneurism in one patient at the tibial group, but was closed by ultrasonic guided compression.
Hematoma in three patients does not need intervention, bleeding at one patient and thrombosis had been occurred in one patient, and in one tibial artery, and treated conservatively by anticoagulants in group A.
Conclusion: The primary patency at multilevel arterial disease is better than isolated tibial arterial disease, this may
reflect increased distal disease burden for those patients who undergo isolated tibial intervention and associated arch
disease. The healing process at multilevel arterial disease is better than isolated tibial arterial disease. Complications are
low at the endovascular intervention, and it is one of the advantages of this area.

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