October 2014
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9 Reads
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2 Citations
Angiología
Objectives To describe the results of infra-popliteal angioplasty in patients with critical ischaemia, as well as to determine the prognostic factors of the results of the procedure. Material and methods A retrospective study on a patient cohort with critical ischemia treated with infra-popliteal angioplasty. Variables were collected on the demographic characteristics, comorbidities, clinical presentation, arteriography features of the affected vessels, and the affected angiosome. A description of the procedure and the post-angioplasty results were also recorded. The events analysed were, the overall survival, amputation-free survival, and the healing of trophic lesions. Results A total of 124 limbs were operated on in 120 patients between January 2011 and December 2013. The technical success was 92%. The median follow-up was 12.6 months. The overall survival at 6, 12, 18, and 24 months was 91.4%, 89.4%, 82.8% and 76.3%, respectively. The amputation-free survival at 12 and 24 months was 88.1% and 76.3%, with 64.3% experiencing an improvement or complete healing of the lesions. Chronic kidney failure was associated with a higher mortality risk (HR: 11.7 95% CI 2.8-48.4). Treatment with statins was associated with a lower mortality (HR: 0.3, 95% CI 0.1-0.9). Patients with ultra-distal arterial involvement had a higher amputation risk (HR: 5.4 95% CI 1.5-18.4). Direct revascularisation of the angiosome was associated with an improvement or complete healing of the wounds (HR: 2.4 95% CI 1.2-4.9). Conclusions Angioplasty of the distal sector is a suitable therapeutic option for survival, limb salvage, and healing of the trophic lesions. The revascularisation strategy as regards the angiosome may be effective for the healing of the wounds.