[Transluminal balloon angioplasty in treatment of lower limb critical ischaemia]

Abstract

Objective of the study: To evaluate efficiency of transluminal balloon angioplasty (TLBAP) in treatment of lower limb critical ischaemia (LLCI).

Materials and methods: Over the period from November 2004 to April 2008, we performed a total of 89 TLBAPs in eighty-two patients presenting with LLCI. The patients' age averagely amounted to 67.8 +/- 9.8 years. Fifty (61%) patients had an ischaemic ulcer on the foot, seventeen (20.7%) had gangrene, and fifteen (18.3%) patients suffered from ischaemic pain at rest. Forty-five (54.9%) patients suffered from diabetes mellitus, including thirty-three (40.2%) subjects with insulin dependent DM. Sixty (73.2%) patients were diagnosed as having coronary heart disease (CHD), sixty-five (79.3%) had arterial hypertension, twenty-five (30.5%) - cerebrovascular disease, and thirteen (15.9%) - chronic renal insufficiency. Six (7.3%) patients were on chronic haemodialysis. The distribution of the patients by the level of the lesion were as follows: iliac 4 (3.6%), femoropopliteal 55 (49.5%), crural artery 52 (46.8%) Type-C and type-D lesions (TASC) were encountered in 89.2% of cases. Occlusions were observed in 82% of all lesions of the crural artery. 42.2% of the patients were treated by means of subintimal angioplasty. Stenting was used in fourteen (7.3%) cases.

Results: The angiographic and clinical success of the procedure was achieved in seventy-five (91.5%) patients. No LLCI was observed either after one or three years in 79.4 and 52.9% of the patients, respectively.