SHORT-TERM OUTCOME OF TIBIAL ANGIOPLASTY IN DIABETIC PATIENTS

Abstract

The practice of tibial angioplasty is likely to increase as more clinicians develop the skills, because it is perceived as a low-risk procedure with a potentially beneficial outcome, which does not jeopardize subsequent alternative treatment. Diabetes mellitus is clearly a significant contributing factor to limb loss due to a combination of ischaemia, infection and neuropathy. The most common and accepted indication for PTA of infra-popliteal vascular disease is in limb salvage patients with chronic critical limb ischaemia (CLI) defined in the Rutherford Becker classification as categories 4, 5 and 6. This patient population often has limited surgical options. In addition even short- term patency rates can have the significant clinical benefits of limb salvage and wound healing. Infrapopliteal percutaneous transluminal angioplasty (PTA) is currently indicated in patients with critical limb ischaemia (CLI). Patients with CLI are typically elderly with multiple co-morbidities and limited life expectancy and therefore, a procedure, which is minimally invasive with reduced morbidity and mortality but lesser long-term patency, may be more appropriate than a more invasive procedure with better long-term patency, so this study discusses the role of angioplasty in infrapopliteal arterial occlusive disease, results values and complications.