الفهرس 
Natural history of the infrapopliteal diseaseOnly 14 pages are availabe for public view
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Abstract
Background: Patients with infrapopliteal arterial disease have a high likelihood of coronary heart disease&multiple co-morbidites.PTA is a minimally invasive procedure, which rarely compromises a later surgical procedure, and at the same time preserves the saphenous vein for future coronary or lower extremity distal bypass surgery . The infrapopliteal PTA is much shorter in time&of lower risk than surgical option. Repeat PTA, unlike repeat surgical bypass operations, can be easily performed in case of restenosis.For all these reasons, many vascular units now consider endovascular treatment as the first treatment option in critical limb ischaemia and reserve surgical revascularization for those where endovascular treatment has failed.
Purpose: The aim of the work is to prospectively assess the short&intermediate term results of percutanous infragenicular arterial revascularizations.
Methods:77patients with infrapopliteal arterial disease referred for percutaneous transluminal angioplasty constituted the population of the study.The data regarding each patient at the time of the intervention and details about the procedure& its success,inhospital mortality&morbidity were registered prospectively.12months follow up data was collected as regards ;mortality, recurrence of ischemia&causes of the recurrence of:(target lesion, target vessel or other vessel),type of ischemia,amputation.Methods of assessment were clinical examination,arterial U/S,+/-angiography ,+/-MSCT.
Results:The technical success rate of the procedure was 89.6%.The percentage of in-hospital mortality was 6.5 %.Deaths were related to bleeding(20%),DIC(40%),septicemia(40%).In-hospital morbidity(hematoma) occurred in 5.1 % of patients.The percentage of 1year survival was 82%.The 1year limb salvage rate was 81.5%.The rate of recurrence of the LL symptoms was 25%, (68% was due to target lesion restenosis ,12% was due to other lesion in the same vessel, 18.75% was due to lesions in other vessel, confirmed mainly by duplex).
Conclusions:Infrapopliteal angioplasty is a good&effective therapy for treating CCLI with a reasonable safety profile in a high risk group of patients with multiple co-morbidites.
Keywords: Percutanous infragenicular angioplasty– Critical limb ischemia- Arterial Doppler ultrasound.