Background
Angioplasty carries lower morbidity and mortality in comparison with surgery and would be considered as the treatment of choice in majority of patients with critical limb ischemia,. Endovascular procedures conventionally employ ionic contrast agent and radiation.
Aim of the work
We aim to evaluate infra-popliteal balloon angioplasty in critical limb ischemia under duplex ultrasound (U/S) guidance to avoid the potential side effects of ionic contrast agent and radiation.
Patients and methods
A prospective study on 28 patients with infra-popliteal steno-occlusive disease was admitted to our Vascular Department during a period from July 2016 to June 2018. Duplex guidance was used for patients with stenotic and occlusive lesions to perform balloon dilation. Seven patients presented with diagnostic computed tomography angiography preprocedure in the outpatient clinic and confirm the diagnosis with duplex U/S study and the rest of the patients was diagnosed by duplex U/S to avoid the hazards of angiography and then follow-up scanning by duplex U/S were done after 1 week, 1 month, and 6 months.
Results
The early technical success rate was 92.9%. Primary patency rate was 92.9, 85.7, and 78.6% after 1 week, 1 month, and 6 months, respectively. Immediate clinical success to all patients with rest pain (100%) and there was clinical improvement in wound healing after 1 month and 6 months (91.7%).
Conclusion
Angioplasty of infra-popliteal arterial occlusive disease under Duplex guidance should be more harmless than using fluoroscopy and effective procedure with accepted results.