Percutaneous transluminal angioplasty for management of critical ischemia in arteries below the knee

Percutaneous transluminal angioplasty (PTA) can be performed safely in arte ries below the knee by using current coaxial catheters. This study includes 37 consecutive patients treated between March 1992 and March 1999 by PTA f or limb-threatening infrageniculate occlusive artery disease. The mean dura tion of follow-up was 28 months. Limb salvage was achieved in 32 patients. The actuarial limb salvage rate at 2 years was 87 +/- 6%. This study shows that PTA was a viable alternative to surgical treatment for management of c ritical lower extremity ischemia in carefully selected patients. Limb salva ge rates after PTA and conventional surgical revascularization seem compara ble. Based on these findings, we recommend that PTA be attempted, whenever possible, for initial treatment of patients presenting critical, limb-threa tening ischemia due to isolated or multiple stenoses of below-knee arteries .