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Semin intervent Radiol 2014; 31(04): 370-374
DOI: 10.1055/s-0034-1393974
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Treatment of Infrapopliteal Arterial Occlusive Disease in Critical Limb Ischemia

Brian M. Christenson
1   Eastern Radiological Associates, Billings, Montana
,
Paul Rochon
2   Department of Radiology, University of Colorado, Aurora, Colorado
,
Matthew Gipson
2   Department of Radiology, University of Colorado, Aurora, Colorado
,
Rajan Gupta
2   Department of Radiology, University of Colorado, Aurora, Colorado
,
Mitchell T. Smith
2   Department of Radiology, University of Colorado, Aurora, Colorado
› Author Affiliations
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Publication History

Publication Date:
14 November 2014 (online)

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Infrapopliteal Arterial Occlusive Disease

There is increasing evidence supporting endovascular intervention in patients with critical limb ischemia (CLI) and infrapopliteal artery occlusion where in-line flow to the foot can be reestablished. Patients with CLI due to infrapopliteal arterial occlusive disease are a high-risk group in which the current reported amputation and mortality rates at 1 year are 25% and 20 to 25%, respectively.[1] [2] Treatment of infrapopliteal arterial disease is vital to prevent amputation, relieve ischemic pain, heal lower extremity wounds, and prevent gangrene.

Technical success rates are often high (approaching 90%) in infrapopliteal angioplasty, with associated clinical success of approximately 70% in some larger series of patients with CLI.[3] Predictors of a successful outcome include a short occlusion length and minimal vessels or stenoses needing treatment. The updated Trans-Atlantic Inter Society Consensus (TASC)–II guidelines concluded that there is increasing evidence to support the recommendation for angioplasty in patient with CLI and infrapopliteal artery occlusion; lesion length alone is no longer used to determine a recommendation for treatment (as was seen with the TASC-1 guidelines).[1] The following procedure describes our approach to treating infrapopliteal arterial occlusive disease.

 

  • References

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