Abstract
Tibio-peroneal trunk (TPT) lesions are usually categorized as ‘complex’ in anatomical classifications, which leads to the perception that endovascular therapy (EVT) will be challenging and the outcome most likely poor. This multicenter, retrospective cohort study investigates the efficacy of the EVT of TPT lesions in patients with chronic limb threatening ischemia (CLTI) or an infrapopliteal bypass at risk. The primary endpoint was limb-salvage. The secondary outcomes were technical success, freedom from clinically driven target lesion revascularization (CD-TLR), overall survival, and amputation-free survival. A total of 107 TPT lesions were treated in 101 patients. At 3 years, the limb-salvage rate was 76.4% (95% CI 66.0–86.8%). Technical success was achieved in 96.3% of cases. The freedom from CD-TLR, amputation-free survival, and overall survival at 3 years were 53.0% (95% CI 38.1–67.9%), 33.6% (95% CI 23.0–44.2%), and 47.7% (95% CI 36.1–59.3%), respectively. Reintervention significantly increased the hazard ratio for amputation by 7.65 (95% CI 2.50–23.44, p < 0.001). Our results show that the EVT of both isolated and complex TPT lesions is associated with high technical success and acceptable limb-salvage rates, with reintervention being a major risk factor for amputation. Moreover, mid-term mortality rate was relatively high. In future revisions of the anatomical grading scales, the classification of TPT lesions as highly complex should be reconsidered.
Highlights
Peripheral artery occlusive disease (PAOD) is common and often disabling
The first clinical manifestation is intermittent claudication, which in 15% of patients gradually progresses into chronic limb-threatening ischemia (CLTI) [1]
The aim of this study is to investigate the efficacy of the endovascular therapy (EVT) of Tibio-peroneal trunk (TPT) lesions in patients with CLTI or an infrapopliteal bypass at risk in terms of technical success, the need for target lesion revascularization, and amputation-free survival
Summary
Peripheral artery occlusive disease (PAOD) is common and often disabling. The first clinical manifestation is intermittent claudication, which in 15% of patients gradually progresses into chronic limb-threatening ischemia (CLTI) [1]. Patients with advanced CLTI are at high risk of major amputation and have a reported mortality rate of 25% within the first year after diagnosis [2,3]. Revascularization therapy is the primary treatment for patients with CTLI. For patients with steno-occlusive lesions in the popliteal and infrapopliteal arteries, endovascular therapy (EVT) has become the preferred treatment, and is associated with similar limbsalvage rates, reduced morbidity, higher cost-effectiveness, and shorter hospitalization as compared to surgery [2,3,4,5,6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
