Aim
To evaluate the efficacy of peroneal artery endovascular revascularization as a single-vessel runoff in the management of patients with critical limb ischemia, caused by infrapopliteal arterial occlusive disease.
Patients and methods
This retrospective study was carried out from February 2015 to March 2021 at Sohag University Hospitals on patients complaining of critical limb ischemia, Rutherford category ‘5’ caused by infrapopliteal arterial occlusive disease and with angiographic evidence based on the peroneal artery-only runoff vessel. Patients with technically successful revascularization of the peroneal artery were divided into two groups according to the peroneal artery connections by its terminal branches to the foot arch and its collateral circulations. Group A: patent peroneal artery connected to the pedal arch or associated with considerable collateral circulations and group B: patent peroneal artery with poor collateral circulations to the foot. Limb salvage and wound healing rates were evaluated and compared between the two groups.
Results
Group A consisted of 14 patients while group B consisted of 18 patients. Both limb salvage rate, wound healing rate, and primary patency rate showed highly significant statistical difference (Ë‚0.01). Limb salvage rate was 71.4% (10 patients) in group A and 44.4% (eight patients) in group B. Complete wound healing rate was achieved in 64.3% (nine patients) in group A and 44.4% (eight patients) in group B. Primary patency rate was 64.3% (nine patients) in group A and 27.8% (five patients) in group B.
Conclusion
Peroneal artery as a single-vessel runoff showed a reasonable limb salvage rate especially when it is continued through its branches to the pedal arch. It should not be ignored when there are no other alternatives.