Management of critical situations during percutaneous transluminal angioplasty of lower limb ischemia

Abstract

Background: Percutaneous transluminal angioplasty (PTA) has become the first-line option in the treatment of lower limb ischemia.Objective: is to evaluate the management procedures during percutaneous transluminal angioplasty of lower limb ischemia Patient and Methods: Sixty five patients with manifestations of lower limb ischemia underwent for percutaneous transluminal angioplasty and had developed critical situations during the procedure. In the vascular surgery departments in Al-Hussein university hospital and Agouza police from March 2018 to March 2020.Results: Study on 65 patients showed that; they developed 67 complications. Complications reported were; Dissection in 35 cases (53.8%), Perforation in 20 cases (30.8%), Thrombosis in 6 cases (9.2%). While in 4 cases (6.2%) Arterio-venous fistula has developed and in 2 cases (3.1%) there was a residual stenosis.Most of cases were managed by endovascular approach in 61 cases (93.8%) but 4 cases (6.2%) were managed by surgical methods.Most of cases had saved their limbs and avoided major amputations unless two cases were gone for major amputations. There was no immediate mortality. Conclusion:Critical situations during endovascular interventions are affected by risk factors, clinical presentation, morphological lesion and type of intervention. Most of cases could be managed by endovascular procedures.