• DOI:10.1053/EJVS.2002.1754
• Corpus ID: 25685833

Role of subintimal angioplasty in the treatment of chronic lower limb ischaemia.

@article{Tisi2002RoleOS,
  title={Role of subintimal angioplasty in the treatment of chronic lower limb ischaemia.},
  author={Paul V. Tisi and Alexander H. Mirnezami and Stephanie Baker and J. A. Tawn and Simon D. Parvin and Simon G. Darke},
  journal={European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery},
  year={2002},
  volume={24 5},
  pages={
          417-22
        }
}

• P. Tisi, A. Mirnezami, +3 authors S. Darke
• Published 1 November 2002
• Medicine
• European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

OBJECTIVES
To determine the clinical outcome of subintimal angioplasty (SA) and to assess impact on surgical workload.

DESIGN
Retrospective review of a single radiologist's case series.

MATERIALS
One hundred and twenty two patients with critical limb ischaemia and 26 with claudication.

METHODS
One hundred and fifty eight limbs treated by SA.

MAIN OUTCOME MEASURES
Technical success and complications; cumulative patency, limb salvage and survival; affect of SA on vascular workload.

RESULTS
The technical success rate was 85%. There were 26 procedural complications (16%) but no patient required emergency surgery; 30-day mortality was 3%. Primary and secondary 12-month patency rates were 27 and 33%. Limb salvage rate was 88% at 12 months. SA initially reduced the number of patients needing arterial surgery, although this then increased due to late failure of SA and an increase in de novo bypass.

CONCLUSIONS
SA carries a low risk of major complications and high immediate technical success. Poor long-term patency suggests that SA is not as durable as bypass surgery. However, failed SA did not compromise subsequent surgery, which only became necessary in a proportion of patients. Our data suggests that there is little to be lost by using SA as first-line treatment for patients with limb-threatening ischaemia who are poor operative risks or who have no autologous vein available.