Below the knee PTA in critical limb ischemia results after 12 months: Single center experience

Abstract 

Purpose

Evaluation of angioplasty with bare metal stents in infrapopliteal occlusions or severe stenoses in patients with critical limb ischemia.

Material and methods

Percutaneous stent angioplasty was performed in 58 limbs in 47 patients with critical limb ischemia (CLI) in Rutherford stage 4–6. Lesions with up to 5cm in length with at least one patent vessel below the obstruction were treated. 121 bare metal stents (diameter of 2.5–4mm; length of 18–38mm) were implanted. Follow-up examinations were performed up to 12 months postinterventionally using clinical examination, ABI calculation, and color-coded duplex sonography. Patency rates were calculated on the basis of the Kaplan–Meier analysis.

Results

Technical success was achieved in 100%. Minor complications (hematoma, distal emboli, vessel dissection) were documented in 5.17% (n=3) limbs, respectively. The 3-month, 6-month, and 1-year primary patency rate was 93.0%, 78.9% and 66.7%, respectively. 86.9% of the lesions healed postinterventionally. The cumulative limb salvage rate was 96.6%.

Conclusion

Stent angioplasty in infrapopliteal arteries is a safe and effective technique for the treatment of patients with CLI. By consequent clinical monitoring high secondary patency rates can be achieved. The use of a bare metal stent seems to result in high limb salvage, primary and secondary patency rates in the mid-term follow-up.

Keywords: Critical limb ischemia, PAOD, Tibial arteries, Stent, Angioplasty