Interventional Radiology - Original Article
Outcomes of infrapopliteal angioplasty for limb salvage based on the updated TASC II classification
Department of Interventional Radiology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland.
Department of Interventional Radiology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland; Faculty of Health, Deakin University School of Medicine, Victoria, Australia
Diagn Interv Radiol ; : -
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Purpose: This study aimed to evaluate limb salvage, defined as freedom from major amputation and to identify predictors of major amputation in patients with infrapopliteal peripheral arterial disease (PAD) based on the updated 2015 TASC II anatomic classification treated by percutaneous transluminal angioplasty (PTA).
Methods: This was a retrospective study of infrapopliteal PTA procedures performed for PAD over a 4 year period. Patient demographics, medical co-morbidities, risk factors, angiographic imaging, technical details and clinical follow-up were analysed to determine limb salvage rates, technical success and all-cause mortality. Predictors of major amputation following PTA were identified.
Results: One-hundred and twelve patients were treated by infrapopliteal PTA. Most lesions consisted of TASC C (44%) and D (34%) categories, were over 10 cm in length and were occlusive and heavily calcified (89%). Overall technical success was 75% with limb salvage rates of 77% at 1-year and 65% at 3-years following PTA. Smoking, previous stroke or cardiovascular events and anticoagulation use were associated with an increased risk of major amputation following PTA.
Conclusion: PTA of complex infrapopliteal PAD is associated with good intermediate term limb salvage rates.