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The aim of this registry was to prospectively assess the immediate and long term outcome of endovascular revascularization for the treatment of lower limb ischemia.
The outcomes of 87 consecutive procedures in 113 lesions were recorded in two centers over two years .60 % of patients presented with chronic critical limb ischemia (CCLI), 40 % of patients with claudication. 35 % of lesions were supra inguinal, 27 % were infra inguinal lesions and 34 % were infra-genicular lesions. The type of lesions according to TASC classification were: 40% type A, 30% type B,18% type C and 12%. type D .Data of this registry were analyzed for immediate angiographic success, in-hospital morbidities and mortality, limb salvage and one year morbidities and mortality as well as restenosis by duplex.
The angiographic success rate was 87.4%. 3% of patients had in-hospital mortality related mainly to the co-morbidities of the peripheral arterial disease; ‘1% cardiac related, 1% due to septicemia and 1% due to bleeding following gastric stress ulcer; the immediate in-hospital morbidity occurred in 7% mainly related to access site complications, 7% minor hematoma, 7% dissection, the need for urgent surgical intervention was 1%. 1 year follow up in 50 patients was as follows: 86 % were alive, 14 % died, septicemia was a cause of death in 2 %. Recurrence of LL ischemia due to target lesions restenosis were in 10 % of which only 2 % were CCLI, the need for repeated endovascular intervention occurred in 4% of patients and surgical revascularization was needed in 2% only. Limb salvage was 100% .Age and elevated serum creatinine level were independent predictors for in-hospital mortality.
According to this registry endovascular revascularization of the lower limb is a good palliative treatment for CCLI, with high success rate, high percentage of limb salvage and acceptable morbidities including restenosis.
- 2013 American College of Cardiology Foundation