European Journal of Molecular & Clinical Medicine

Abstract

Background: Critical limb ischemia (CLI) is a severe form of peripheral arterial disease (PAD) characterized by clinical findings of lower extremity ischemic pain at rest.The study aimed to discuss the better management of patients with critical lower limb ischemia. Patients and methods: A randomized  control  trails  study  was  included  24  participants  diagnosed  with  critical lower  limb  ischemia  (CLI)  due  to  Infragenicular  lesions  with  mean  age  of  69.01±7.11 years   and conducted  at Vascular  Surgery  Department  at  Zagazig  university  Hospitals. Patients were divided equally into the endovascular therapy (EVT) group and the  bypass  surgical  group. Follow up was done by the Rutherford recommended standards for reports dealing with lower extremity ischemia by using the life table and Kaplan-Meier survival curve. Results:  The study revealed that the arteries that underwent dilatation were 7 anterior tibial arteries, 5 posterior tibial artery, 7 distal popliteal artery and 8 peroneal arteries. There was a significant difference of hemodynamic success among the studied groups. Additionally, there was no significant association of technical success between the studied groups. There were significant differences in limb salvage between the studied groups. The probability of artery patency in endovascular therapy group is higher than in bypass treatment in the 1st month, 2nd month and 4th month. Conclusion: Endovascular techniques are a viable treatment approach for limb salvage in patients with infrageniculate critical limb ischemia, and can be considered as a first-line approach in patients presenting with diabetes and/or tissue loss.