Outcome of Single Tibial Artery Angioplasty in Critical Limb Ischemia

Abstract

Peripheral arterial disease (PAD) presents with 12% to 20% of the elderly patients (aged 65 years and older). Critical limb ischemia (CLI) represents the most severe form of PAD; which is a severe obstruction of the arteries which markedly reduces blood flow to the extremities (hands, feet and legs) and has progressed to the point of severe pain and even skin ulcers or sores. In daily practice, CLI patients often have significant lesions in both the anterior tibial artery (ATA) and the posterior tibial artery (PTA). In patients who have progressed to CLI, revascularization of the affected extremity through endovascular intervention plays a crucial role in staving off limb loss, prolonging survival, and improving their quality of life. The aim of this work was to evaluate the outcomes and advantages of single tibial artery angioplasty in critical limb ischemia. In this one arm observational prospective study; 40 patients were selected from the Department of Vascular Surgery- Ain Shams University Hospital from the period of June to December 2018. Patients were subjected to Duplex study and Computerized tomography (CT) angiography for investigation. Patients were treated by single vessel infra-popliteal PTA with or without stent and balloon. Post-intervention medical treatment included: Anti-coagulants & Anti-platelets. Outcome within one month. Complications, Length of stay in hospital & Mortality. - Wound healing at three and six months (Complete or Incomplete). Our results showed that: 1. The mean of age was 60.525 ± 4.013 years. 26 patients (65%) were male while 14 patients (35%) were female. BMI was 23.075 ± 4.299 kg/m2