Percutaneous Revascularisation Of Specific Angiosome In Critical Limb Ischaemia

Introduction and objectives. To determine whether the acquisition of direct flow to ischaemic foot angiosome affects healing and limb salvage in critical limb ischaemia treated by endovascular therapy.Material and methods. Retrospective analysis of 34 consecutive limbs (32 patients) with chronic ischaemia, Rutherford category 5 (n = 21, 61.8 %) and 6 (n = 13, 38.2 %) and successfully treated with endovascular technique, between 2007 and 2009. We created two groups: the direct revascularisation group or DR (revascularised artery directly feeds the ischaemic angiosome) and the indirect revascularisation group or IR (revascularised artery does not directly feed the ischaemic angiosome). The variables analysed were: complete healing, healing time and limb salvage rates. Statistical analysis included Chi-square test and survival tables.Results. We included 34 limbs who underwent recanalisation (n = 27, 79.4 %), simple angioplasty (n = 3, 8.8 %) and angioplasty with stents (n = 4; 11.8 %). The DR group included 18 (52.9 %) limbs and the IR group 16 (47.1 %). We did not find significant differences when comparing comorbidities. There was complete healing in 76.5 % (n = 26) of the wounds and there were no difference in the total healing time (157.8 days in DR against 124.5 days in IR). There were no differences when comparing the success of complete healing (DR n = 14 [77.8 %] against IR n = 12 [73.7 %]) and the limb salvage rate per year ( 89 % DR against 84 % IR).Conclusion. In our series, the direct or indirect revascularisation angiosome does not affect the rate of healing and limb salvage. (C) 2010 SEACV. Published by Elsevier Espana, S.L. All rights reserved.