ANGIOPLASTY GIVES GOOD RESULTS IN CRITICAL LOWER-LIMB ISCHEMIA - A 5-YEAR FOLLOW-UP IN PATIENTS WITH KNOWN ANKLE PRESSURE AND DIABETIC STATUS HAVING FEMOROPOPLITEAL DILATATIONS

137 consecutive patients with known ankle pressures and diabetic statu s had attempted femoro-popliteal dilatation for lower limb ischaemia i n an English provincial teaching hospital. All except one were followe d until failure or death to assess survival and amputation rates. Non- diabetic patients with critical limb ischaemia had a 5 year survival r ate of 62.2% (SE 17.1) compared to 50.5% (SE 7.0) for claudicants, wit h no significant difference on logrank testing. Diabetics had a relati ve risk of amputation of 11.2 compared to nondiabetics. Patients with pre-treatment ankle pressures of 50 mm or less had a relative risk of amputation of 2.6 compared to those with higher resting pressures. It is concluded that angioplasty should be the treatment of first choice in critical lower limb ischaemia whenever it is technically possible. Including patients with rest pain in the critical ischaemia group does not significantly affect cumulative patency rates.