Mid-term outcomes of endovascular interventions of critical lower-limb ischemia in patients with chronic renal failure

Objective Investigating the early results of percutaneous transluminal angioplasty of chronic lower-limb ischemia in patients with chronic renal failure. Background The concern that endovascular treatment of chronic lower-limb ischemia in patients with chronic renal failure is gaining popularity nowadays since the increase in morbidity and mortality rates in bypass surgery makes the procedure difficult for these patients. Patients and methods In total, 40 limbs in 40 consecutive patients (28 male, mean +/- SD age 59.65 +/- 8.54) were analyzed, 28 with lesion, either gangrene or ulcer, and 12 with rest pain. The follow-up of healing and foot vascularity was done at regular periods and up to 1 year as ABI was not a good indicator for follow-up because of the high false results due to severe calcification. Results After 12 months, the end results of the study are as the following: 10 (25%) cases were relieved from rest pain, another 12 (30%) cases had healed lesion, and three (7.5%) cases had major amputation, 11 (27.5%) cases had return of the same complaint as preoperative by the end of 12 months. Conclusion Despite improvement in endovascular techniques and their increasing utilization for lower-extremity revascularization, peripheral revascularization in chronic renal-failure patients has not led to high limb-salvage rate. Poor outcomes may be related to the severity of ischemia on presentation, the cumulative burden of the atherosclerotic disease, and the distal location of the disease.