[Peripheral angioplasty in patients with lower limb critical ischaemia after operations of femoropopliteal bypass grafting].

The study was aimed at retrospectively assessing the outcomes of peripheral angioplasty (PAP) in patients presenting with lower limb critical ischaemia (LLCI) after previously endured operations off emoropopliteal bypass grafting (FPBG). The PAP procedure was carried out in a total of nine patients diagnosed with LLCI meeting the criteria of the Trans-Atlantic Inter-Society Consensus (TASC), in whom repeat bypass grafting was recognized impossible owing to the absence of either shunting-fit veins or arterial segments suitable for anastomosing. Of these, eight patients had a femoropoplietal bypass graft implanted previously, and the remaining patient had a femoral-anterior-tibial one. In four cases, the patency of the shunts was preserved but all the three tibial arteries were occluded. Five patients displayed total occlusion of the shunts. In 80% of cases, the PAP procedure was performed in C and D types of morphology of the arterial lesion according to the TASC criteria. The PAP procedure was technically successful in eight (89%) patients, making it possibly to re-establish blood supply to the foot along at least one tibial artery. No clinically significant complications following PAP in the treated patients were observed. The average duration of follow up amounted to 9 months. Technically successful PAP was accompanied by clinical success in all the cases. During the follow-up period, one patient died from myocardial infarction with no signs of LLCI. A relapse of LLCI was observed in one (12.5%) patient. The obtained findings suggest that in the treated patients with LLCI after FPBG and impossibility of performing repeat bypass grafting, PAP proved to be a safe and efficient method of revascularization.