Department of Radiology, Atrium Medical Center, Henri Dunantstraat 5, Heerlen, The Netherlands 6419.
J Vasc Interv Radiol. 2012 Apr;23(4):461-7, 467.e1. doi: 10.1016/j.jvir.2011.12.011. Epub 2012 Feb 1.
To evaluate the technical success and clinical long-term effectiveness of percutaneous transluminal angioplasty (PTA) of the infrapopliteal arteries in critical limb ischemia (CLI) and to determine if total vessel dilation (TVD) increases the limb salvage rate (LSR).
A retrospective study was performed in 90 consecutive patients (35 men and 55 women, median age 79 years, standard deviation [SD] 9 years) over a 5.5-year period to determine the effectiveness of infrapopliteal PTA in treating CLI. Of 90 patients, 61 underwent TVD. Analysis of LSR was performed using the Kaplan-Meier life-table analysis.
In 90 limbs, there were 57 infrapopliteal stenoses and 104 occlusions. Including 10 technical failures (TF) (TF = 11%), LSR at 1 year and 3 years for all 90 patients with previously untreated lesions was 78%. For 80 technically successful (TS) procedures (TS = 89%), LSR at 1 year and 3 years was 87%. At 1 year and 3 years, LSR for the 61 patients who had TVD was 89%. In all patients, there were no amputations after the first year. The 30-day mortality rate was 7%.
PTA of the infrapopliteal arteries appears to be an effective treatment for patients with CLI. TVD provides an improved LSR and warrants additional evaluation.
评估经皮腔内血管成形术（PTA）治疗严重肢体缺血（CLI）患者的下肢动脉的技术成功率和临床长期疗效，并确定全血管扩张（TVD）是否会提高肢体存活率（LSR）。
对 90 例连续患者（35 例男性，55 例女性；中位年龄 79 岁，标准差 [SD] 9 岁）进行回顾性研究，以确定经皮腔内血管成形术治疗 CLI 的有效性。90 例患者中，61 例行 TVD。采用 Kaplan-Meier 生命表分析进行 LSR 分析。
90 条肢体中，有 57 条下肢动脉狭窄和 104 条闭塞。包括 10 例技术失败（TF）（TF=11%），所有未经治疗病变的 90 例患者的 1 年和 3 年 LSR 为 78%。80 例技术成功（TS）的手术（TS=89%），1 年和 3 年的 LSR 为 87%。在 61 例行 TVD 的患者中，1 年和 3 年的 LSR 为 89%。所有患者在第一年均未截肢。30 天死亡率为 7%。
下肢动脉 PTA 似乎是 CLI 患者的有效治疗方法。TVD 可提高 LSR，值得进一步评估。
