Outcomes after Angioplasty of Isolated, Below-the knee Arteries in Severe Limb Ischemia

Abstract

Background: Few published studies have specifically investigated outcomes in ischemic limbs associated with isolated small BTK (Below- The-Knee) vessel disease. This study aimed to evaluate the results of successful endovascular treatment for limb salvage in such patients. Materials and methods: From among the 675 endovascular procedures on lower extremity arteries in our database, we retrospectively selected a consecutive series of 44 procedures on isolated BTK lesions on 41 limbs in 39 patients from 2010 to 2017. The Target Lesion Revascularization (TLR) free rate, limb salvage and patients’ survival were investigated. Results: Mean age was 63.8 ± 14.0 years, and mean follow-up duration was 18.1 ± 16.5 (range, 0.1 – 80.2) months. During followup, repeated procedures were needed in 6 limbs (14.6%) for recurrent ischemia. 13 patients (33.3%) had died because of medical conditions unrelated to angioplasty. The TLR free rate at 1 year, 3 years, and 5 years were 85.7%, 79.1%, and 79.1%, respectively. Amputation-free survival at 1 year, 3 years, and 5 years were 73.0%, 41.2%, and 41.2%, respectively. Conclusions: In our selected patient population with ischemic limbs and isolated BTK lesions, a successful endovascular procedure led to an acceptable TLR free rate and relatively low amputation free survival.