PERCUTANEOUS BALLOONDILATION OF ISOLATED LESIONS IN CRURAL ARTERIES WITH CRITICAL LIMB ISCHEMIA

Between 1990 and 1993 we performed 42 percutaneous transluminal balloo nangioplasties (PTA) in 30 patients with isolated lesions of crural ar teries and limb threatening ischaemia. The average age of the patients was 70.5 years, 90% were diabetics. With low-profile balloon catheter s between 2 and 4 mm we dilatated 15 tibioperoneal trunks, 12 anterior tibial arteries, 3 posterior tibial arteries and 12 peroneal arteries . Initial success was achieved in 83% of the dilatations with an avera ge increase of ankle-brachial index of 0.18. After PTA two groin haema tomes as the only complications were observed. In 22 cases healing of the acral lesions under local surgical treatment was seen. Two of the clinical unsuccessful patients required popliteopedal bypass surgery a nd 5 below-knee amputation because of lacking reconstructive possibili ties. The follow-up period varied from 1 to 35 months (mean 10.3 month s). Life cable analysis showed a cumulative limb salvage rate of 82% a fter one and two years. The PTA of infrapopliteal artery stenoses and occlusions is considered as an effective and safe therapy modality to avoid below-knee amputation in patients with limb threatening ischaemi a.