Endovascular Revascularization in Chronic Limb-Threatening Ischemia

pp. 339-345

Abstract

Background: Management of chronic limb-threatening ischemia (CLTI) is based on surgical or endovascular arterial revascularization. Over the past two decades, the widespread adoption of endovascular treatments has increased their application in patients with CLTI.
Objective: The aim of this study was to describe the results of infrainguinal endovascular revascularization of patients with CLTI due to chronic obstructive arteriopathy.
Methods: We conducted a retrospective analysis of a prospectively followed cohort of 211 patients with CLTI undergoing endovascular treatment between January 2015 and December 2020.
Results: Of the total angioplasty procedures performed, 100 were below the knee (47.4%), 63 were above the knee (29.9%) and 48 were combined (22.7%) procedures. A total of 167 patients (79.2%) underwent primary balloon angioplasty procedures, and stents were placed in 44 (20.8%) cases. Mortality at 30 days was 0.95%. Survival rate at 1.3 and 5 years was 87%, 65% and 51%, respectively. Lower limb salvage was 78% at 1 year, 72% at 3 years and 68% at 5 years. At least one surgical or endovascular reintervention was required in 65.8% of the patients and 63.7% required at least one readmission. Wound healing was achieved in 121 patients, 118 were able to ambulate and 59 had independent ambulatory ability. Only 57 patients (29%) presented ideal results, which means that they achieved limb salvage, wound healing, elimination of ischemic pain and the attainment of independent ambulatory ability during follow-up.
Conclusions: Infrainguinal endovascular revascularization in CLTI proved to be safe and achieved favorable salvage rates. However, the results include a low rate of full functional recovery due to poor independent ambulatory ability and wound healing and high need for reinterventions during follow-up.

How to cite this article:

Bevacqua R, Norese M, Shinzato S, Damonte HM, Heredia EN. Revascularización endovascular en isquemia crítica de miembros inferioriores. Rev Argent Cardiol 2024;92:339-45. http://dx.doi.org/10.7775/rac.v92.i5.20815