Resultados de la angioplastia simple en pacientes con isquemia crítica debida a enfermedad exclusiva del sector infrapoplíteo

Abstract

IntroductionCritical limb ischaemia is defined as rest pain, limb ulcers, or gangrene (IV- VI Rutherford Classification) in patients with peripheral arterial disease. Endovascular treatment has been shown to be a suitable option in below-the-knee lesions. Materials and methodsA retrospective, descriptive study was conducted on patients diagnosed with critical limb ischaemia secondary to isolated infrapopliteal lesions, registered in our centre from 2005 to 2015. Diagnosis was made with Doppler ultrasonound mapping and intra-operative angiography. Technical success was defined as performing one vessel angioplasty. Primary end-point was overall limb salvage. Secondary end-points were described as clinical success, and overall mortality. ResultsThe study included a total 72 limbs of 68 patients (53 men and 15 women) with a mean age of 73.4 ± 11.4 years. Of these, 75% were hypertensive, 80.5% were diabetics, 22% had renal failure. A Rutherford classification of v-vi was observed in 86% of patients. One-vessel angioplasty was the most frequent treatment in 59.8%, and 2 or more vessels in 40.2%. There was 97% technical success. Overall limb salvage was 75%. Clinical success rates at 6, 12 and 24 months were 72, 47.2, and 26.4%, respectively. The median hospital stay was 18 days (range 12-35), with a median follow-up of 365 days (range 180-730). Overall mortality during follow up was 25%. ConclusionOur results are similar as those described in the literature, and demonstrate that balloon angioplasty is a useful technique in critical limb ischaemia patients with infrapopliteal lesions, and has an adequate limb rate salvage.