Inge Kaare Tesdal MD, Presenter: Nothing to Disclose

Christian Krzemien MD, Abstract Co-Author: Nothing to Disclose

Christel Weiss, Abstract Co-Author: Nothing to Disclose

To evaluate the technical and clinical success rates, procedure-related complications, and long-term results for patients who underwent angioplasty of the crural arteries.

Retrospectively we evaluated all patients who underwent angioplasty of the crural arteries due to critical chronic limb ischemia or severe claudication in the time period from 1/2002 to 12/2005. These patients were contacted in the time period from 1/2009 to 12/2010, and a follow-up examination including angiography was performed or telephone interviews were conducted with patients, relatives and referring doctors for follow-up. The primary end points were the limb salvage rate and patient survival rate. The secondary end points included the complication rate, technical success rate, and patency rate. The prognostic relevance of treatment and selected variables with respect to limb salvage and patient survival were analyzed with multiple logistic regression

212 patients with a mean age of 77.8 years (99 women and 113 men) underwent crural angioplasty on 239 limbs. 78 patients (32.6%) suffered from severe claudication (Rutherford category 3) and all others had critical chronic limb ischemia (category 4 to 6, resp. Fontaine-stage 3 and 4). The technical success rate was 98.4 % and the complication rate (SIR classification) was 9.1 % (5.2 % major). After a mean follow-up of 3.7 years, 48 patients (22.6 %) experienced minor- or major-amputation on 53 legs (22.2 %). The limb salvage rate (Kaplan-Maier estimation) was 85.4 % after 5 years. The mean survival rate according to Kaplan-Meier was 79.7 %, 72.2 %, 67.3 % and 51.4 % after 1, 2, 3 and 5 years, respectively. Results of multiple logistic regression analysis showed that negative prognostic variables with respect to patient survival were amputation (p=0.0017) and dialysis (p=0.0011) and with respect to limb salvage dialysis (p<0.0001) and non-patent peroneal artery (p<0.0001).

Balloon angioplasty of the crural arteries shows a high technical success rate with an acceptable complication rate. Dialysis and non-patent peroneal artery are negative prognostic variables for the clinical long-term success. However, the survival rate was limited by the co-morbidity and the high age in this patient group.

Peroneal artery should be the preferred crural artery to be recanalized

Tesdal, I, Krzemien, C, Weiss, C, Long-term Results after Balloon Angioplasty of the Crural Arteries: Which Variables Influence Limb Salvage and Patient Survival?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006772.html