Angiosome-Targeted Infrapopliteal Balloon Angioplasty in Patients With CLI


January 16, 2018—Online in European Journal of Vascular and Endovascular Surgery (EJVES), Ahmed Elbadawy, MD, et al published findings from a prospective study evaluating complete wound healing and limb salvage rates after angiosome-targeted infrapopliteal balloon angioplasty in patients with critical limb ischemia (CLI).

As explained in EJVES, this prospective observational study was composed of 212 patients with concurrent foot ulceration/gangrene who underwent successful infrapopliteal balloon angioplasty to assist wound healing and achieve limb salvage from June 2014 to March 2016. Propensity score matching was developed to compare complete wound healing, 1-year amputation-free survival (AFS), and limb salvage rates between the two study groups: direct revascularization and indirect revascularization.

The investigators reported that direct flow to the foot wounds based on the angiosome principle was achieved in 117 legs (55.2%) versus 95 legs (44.8%) that represented the indirect revascularization group. The investigators obtained 73 matched pairs to minimize intergroup differences in baseline characteristics. At 12 months after angioplasty, the complete wound healing rates were 80.8% and 63% (P = .02), AFS rates were 72.6% and 61.6% (P = .164), and limb salvage rates were 90.4% and 82.2% (P = .148) in the direct and indirect revascularization groups, respectively.

This study suggests that the complete wound healing rate is better when the target foot lesion receives direct perfusion following the angiosome concept, whereas limb salvage and AFS rates were not significantly different among the direct and indirect revascularization groups, concluded the investigators in EJVES.


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