Abstract 3837: Complete Revascularization to the Pedal Arch Improves the Limb Salvage Rate in Patients with Critical Limb Ischemia
Background: Recent advances in endovascular devices have permitted revascularization as far as to the pedal arch. However, whether complete revascularization to the pedal arch (CR) improves the limb salvage rate in patients with critical limb ischemia (CLI) is unknown. We investigated the limb salvage rates in patients with CLI who underwent CR as well as in those without CR.
Methods: Total 54 limbs with non-healing foot ulcer from 42 patients (age ranged 53–88 years; including 28 men) whose skin perfusion pressure (SPP) in the lower foot was measured between July 2005 and March 2006 were analyzed. Mean follow up period was 4.2±2.1 months. Lesions were located above the knee in 1 limb (2%), below the knee in 22 limbs (41%), and both above and below the knee in 31 limbs (57%). SPP was measured using a cuff type laser Doppler scanner designed for this purpose. The limbs were retrospectively analyzed according to the percutaneous peripheral intervention procedures: with (WCR, n=32) or without (NCR, n=22) CR. Improvement in SPP and the rate of limb salvage were compared between the groups.
Result: Patient and lesion characteristics were similar between WCR and NCR. Improvement in SPP was greater in WCR than in NCR (42±26mmHg versus 14±14mmHg, p<0.0001). The limb salvage rate was significantly greater in WCR than in NCR (94% versus 68%, p=0.013).
Conclusion: Complete revascularization to the pedal arch improves the skin perfusion pressure and resulted in a better limb salvage rate than standard revascularization in patients with critical limb ischemia.