SHORT-TERM OUTCOMES OF ENDOVASCULAR INTERVENTION OF INFRAINGUINAL ARTERIES IN PATIENTS WITH CRITICAL LIMB ISCHEMIA

Main treatment goal of critical limb ischemia is arterial revascularization and limb salvage. In present study short term outcomes of endovascular treatment of infrainguinal lesions were evaluated in 28 patients (28 limbs) with critical limb ischemia treated from July 2013 to December 2014. The study included 24 men (85.7%) and 4 women whose mean age was 64.8 +/- 8.75 years. TASC II (Trans Atlantic Inter Society Consensus II) C or D type lesions were represented in 85.7% of patients. From conducted 28 interventions 11 (39.3%) were hybrid, including open endarterectomy from common femoral artery with or without profundoplasty. Balloon angioplasty was enough for achieving technical success in 4 cases (1 4.3%). Overall 32 stents were implanted in 24 (85.7%) patients. In 19 cases (67.9%) balloon angioplasty of infrapopliteal arteries was performed to establish at least 1 vessel runoff to the foot. Positive outcomes were achieved in 27 patients (96.4%). The mean ankle-brachial index increased from 0.39 +/- 0.19 before intervention to 0.8 +/- 0.21 after revascularization. During 3-18 months follow-up (mean - 5.4 months) clinically driven target lesion revascularization was necessary in 4 cases (14.3%), 3 of these patients had in-stent thrombosis, and one had in-stent restenosis. There were 7 minor and one major amputation (limb salvage rate was 96.4%). One patient died in 7 months after procedure due to oncological disease. Conducted study demonstrates that endovascular treatment of patients with critical limb ischemia is safe and viable, even in cases of complex TASC II C/D lesions of the femoropopliteal segment with acceptable short-term (approximate to 6 months) patency and limb salvage rates.