Endovascular Balloon Angioplasty in Management of Infragenicular CLI

Critical limb ischemia is associated with high rates of limb loss & mortality. Within 6 months of presentation with CLI, 25% of patients will require major amputation. An estimated 250,000 major amputations are performed annually in the United States & Europe, resulting in a significant socioeconomic burden & reduction in quality of life indicators. Published rates of mortality for CLI approach 25% at 1 year &50% at 5 years. Among revascularization methods, surgical bypass has been regarded as the gold standard, with better anatomical and clinical durability. However, patients with CLI are often aged & not optimal candidates for surgical bypass due to medical co-morbidities. This has rendered minimally invasive procedures superiority in the recent era. Interventional therapy for tibial arteries is a key part of the vascular specialist armamentarium. Tibial artery interventional therapy has been proven to lead to limb salvage with low morbidity and mortality in patients with CLI & should be used as a first line treatment in the majority of patients, especially in those with significant medical co-morbidities. This project aims at comparing different modalities for intervention.

Autorentext

Mohamed Mahmoud Mohamed Zaki Ali; Vascular Surgery Lecturer, Ain Shams University, Cairo, Egypt. Obtained Bachelor Degree in Medicine & Surgery in 2007 & awarded the Master Degree in Surgery (MSc) from Ain Shams University in 2011. Attained Membership of the Royal College of England in 2012. This research project was the final step in obtaining my MD.

Klappentext

Critical limb ischemia is associated with high rates of limb loss & mortality. Within 6 months of presentation with CLI, 25% of patients will require major amputation. An estimated 250,000 major amputations are performed annually in the United States & Europe, resulting in a significant socioeconomic burden & reduction in quality of life indicators. Published rates of mortality for CLI approach 25% at 1 year & >50% at 5 years. Among revascularization methods, surgical bypass has been regarded as the gold standard, with better anatomical and clinical durability. However, patients with CLI are often aged & not optimal candidates for surgical bypass due to medical co-morbidities. This has rendered minimally invasive procedures superiority in the recent era. Interventional therapy for tibial arteries is a key part of the vascular specialist armamentarium. Tibial artery interventional therapy has been proven to lead to limb salvage with low morbidity and mortality in patients with CLI & should be used as a first line treatment in the majority of patients, especially in those with significant medical co-morbidities. This project aims at comparing different modalities for intervention.