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CardioVascular and Interventional Radiology

, Volume 33, Issue 3, pp 469–474

First Online: 18 August 2009Received: 02 June 2009Revised: 15 July 2009Accepted: 22 July 2009


Patients with severe critical limb ischemia CLI due to long tibial artery occlusions are often poor candidates for surgical revascularization and frequently end up with a lower limb amputation. Subintimal angioplasty SA offers a minimally invasive alternative for limb salvage in this severely compromised patient population. The objective of this study was to evaluate the results of SA in patients with CLI caused by long tibial occlusions who have no surgical options for revascularization and are facing amputation. We retrospectively reviewed all consecutive patients with CLI due to long tibial occlusions who were scheduled for amputation because they had no surgical options for revascularization and who were treated by SA. A total of 26 procedures in 25 patients 14 males; mean age, 70 ± 15 SD years were evaluated. Technical success rate was 88% 23-26. There were four complications, which were treated conservatively. Finally, in 10 of 26 limbs, no amputation was needed. A major amputation was needed in 10 limbs 7 below-knee amputations and 3 above-knee amputations. Half of the major amputations took place within 3 months after the procedure. Cumulative freedom of major amputation after 12 months was 59% SE = 11%. In six limbs, amputation was limited to a minor amputation. Seven patients 28% died during follow-up. In conclusion, SA of the tibial arteries seem to be a valuable treatment option to prevent major amputation in patients with CLI who are facing amputation due to lack of surgical options.

KeywordsSubintimal angioplasty Tibial arteries Critical limb ischemia  Download fulltext PDF

Autor: Rosemarie Met - Mark J. W. Koelemay - Shandra Bipat - Dink A. Legemate - Krijn P. van Lienden - Jim A. Reekers


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