Comparison of drug eluting balloon angioplasty to infrapopliteal artery critical lesions with or without additional pedal artery angioplasty in patients with diabetes mellitus and critical limb ischemia

Abstract

Our study shows that additional BTA angioplasty to BTK intervention may improve the primary patency rate and have higher event free rate, which slightly missed the margin of statistically significance. RBC decreased significantly more in BTA group compared to BTK group, which reflected that the outcome of intervention is better with additional BTA angioplasty.

Below-the-Ankle Angioplasty in Patients with Critical Limb Ischemia: A Systematic Review and Meta-Analysis

“…After duplicates were removed and the titles and abstracts were screened for relevance, 39 full-text articles were assessed for eligibility. Applying the inclusion and exclusion criteria resulted in 10 articles (11)(12)(13)(14)(15)(16)(17)(18)(19)(20) being finally included in this systematic review. A flow chart of the selection procedure is shown in Figure 1.…”

“…All included patients had CLI and were classified as Rutherford category 4 (44 legs) or 5 or 6 (420 legs). Two studies (11,18) included patients with Rutherford category 4 but did not specify the number of legs per Rutherford category (60 legs). Two studies (15,16) excluded patients with patent dorsal and lateral plantar arteries (Kawarada classification type 1 pedal artery disease) (21).The other studies did not report exclusion criteria (11)(12)(13)(14)(17)(18)(19)(20).…”

“…The lesions treated were located in the plantar artery, dorsalis pedis artery, or distal (inframalleolar) posterior tibial artery. If inflow lesions were present, these were treated in the same procedure as the BTA lesions in almost all studies (11,12,(14)(15)(16)(17)(18)(19)(20). In 1 study, the BTK lesions were treated before the BTA intervention took place (13).…”

“…In 1 study (14), the target arteries were both pedal and plantar arteries and their anatomical anastomosis. The target artery in the other studies (11)(12)(13)16,(18)(19)(20) was based on the arterial lesion location. All studies reported technical success, which ranged from 63% to 95%.…”

“…All studies reported technical success, which ranged from 63% to 95%. Complications were reported in 6 studies (11,13,15,(18)(19)(20) and included vessel perforation (n ¼ 7), subacute occlusion (n ¼ 12), balloon rupture (n ¼ 3), puncture hematoma (n ¼ 7), retroperitoneal hematoma caused by puncture (n ¼ 1), heart failure (n ¼ 1), and stroke (n ¼ 1).…”