lCLINICAL INVESTIGATION l Subintimal Angioplasty of Isolated Infragenicular Vessels in Lower Limb Ischemia: Long-term Results

l l Purpose: To assess the outcome of subintimal angioplasty in treating isolated infragenicu-lar arterial disease in patients with severe lower limb ischemia. Methods: A retrospective study reviewed 67 consecutive patients (39 men; mean age 76 years, range 41±96) who underwent infragenicular subintimal angioplasty between March 1997 and May 2000 for ischemia in 70 limbs. The median length of occlusion was 6 cm (range 1±10) in the below-knee popliteal arteries, 4 cm (range 1±4) in the tibioperoneal trunk, 21 cm (range 1±35) in the anterior tibial artery, 10 (1±30) in the posterior tibial artery, and 5 (range 1±20) in the peroneal artery. Results: The technical and clinical success rates were 86 % and 80%, respectively. In the 10 (14%) patients with a technical failure, 3 underwent successful bypass, 4 had an am-putation, 1 had a lumbar sympathectomy, and 2 were treated conservatively. Of the 4 (6%) limbs that did not achieve clinical success, 2 patients required femorodistal bypass and their ulcers improved; in the other 2, ulcerations did not heal completely. The cumulative limb salvage rate and freedom from critical limb ischemia (CLI) quanti®ed by Kaplan-Meie