Remote results of endovascular revascularization in patients with lower limb critical ischaemia (LLCI) kept on chronic

Kaputin M.Yu.^1,2, Platonov S.A.², Ovcharenko D.V.², Voronkov A.A.², Kiselev M.A.²

1) St. Petersburg State Medical University named after I.P. Pavlov,
2) St. Petersburg Scientific Research Institute for Emergency Ambulance Care named after I.I. Dzhanelidze, St. Petersburg, Russia

The study was aimed at assessing remote results of endovascular treatment of patients presenting with lower limb critical ischaemia (LLCI) and kept on chronic haemodialysis.

We retrospectively analysed the results of endovascular interventions in a total of 16 patients with ischaemic defects of the foot being on chronic haemodialysis, performed from 2001 to 2012 at the Department of Roentgenosurgical Methods of Diagnosis and Treatment of the St. Petersburg Scientific Research Institute for Emergency Ambulance Care named after I.I. Dzhanelidze. The patients’ age varied from 39 to 75 years (mean 56.2±12.8 years). There were 11 (68.7%) men and 5 (31.3%) women. Ten patients (62.5%) suffered from diabetes mellitus. Of the ten diabetic patients, nine (56.2%) received insulin. A total of 21 endovascular interventions were performed on 16 extremities. The obtained findings were statistically processed by means of the Kaplan-Meier method.

During follow up, LLCI relapses were observed in eleven (68.7%) patients, amputation of the femur was performed in eight (50%) patients, and five (31.2%) patients survived without major amputation. One year and two years after intervention, the probability of LLCI relapse absence amounted to 37.5 and 30%, respectively, that of major amputation – to 67.5 and 24.1%, survival without major amputation – to 50 and 17.9%, respectively.

Patients with LLCI kept on chronic haemodialysis belong to a group of high risk of limb loss and a lethal outcome within 2 years after angioplasty.

KEY WORDS: lower limb critical ischaemia, chronic haemodialysis, balloon angioplasty.

P. 52

« Back