Our experience of infrapopliteal revascularization of lower extremity in ten years

Objective: In this study the long term results of infrapopliteal arterial revascularization procedure was evaluated. The efficiency of distal revascularization was also searched for the treatment of critical limb ischemia.

Methodology: From 1999 to 2009 32 patients underwent infrapopliteal revascularization procedure in our hospital for the treatment of critical limb ischemia. Demographic data of patients are: 23 male, 9 female and mean age was 60.5. Hypertension (n:15, 46.3%), diabetes mellitus (n:16, 50%), smoking (n:29, 90.6%) were the risk factors. The patients were classified in Fontaine III (n:25) and Fontaine IV (n:7). Extremity viability and long term patency was detected with limb examination, Doppler Ultrasonography and angiography. The cases were evaluated for post operative mortality, morbidity and primary graft patency for one year.

Results: Mean follow up period was 21.3-/+15.9 monthes (12-60 monthes). Two patients died in early post operative period. Eight patients underwent re-operation. Re-operations were performed on six patients for the treatment of acute graft thrombosis and two patients for the control of surgical leeding. The long term graft patency was 38% and extremity recovery rate was 46%. In post operative early period two minor and one major amputation was performed.

Conclusion: Infrapopliteal arterial revascularization procedure is an efficient method for the treatment of critical limb ischemia and high rate of long term patency is the main advantage of this procedure.