Document Detail


Isolated tibial vessel disease: treatment options and outcome.
MedLine Citation:
PMID:  8979737     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Tibial vessel disease is an important cause of limb ischaemia, particularly in diabetics. Revascularisation by angioplasty and bypass is increasingly feasible. The aim of this study was to review treatment and outcome in patients with this patterns of disease. We have performed 25 procedures in 20 patients since September, 1989. Six patients (5 diabetic) underwent 9 tibial angioplasties for stenotic lesions causing critical ischaemia or short-distance claudication. In 6 procedures there was single vessel run-off. Eight angioplasties were radiologically successful with a median increase in ankle-brachial index (ABI) of 0.15 [range: 0.00-0.44] at a median follow-up of 9 months. A further 4 patients (3 diabetic) with critical ischaemia underwent popliteal-distal, in-situ vein bypass for tibial occlusions. Distal anastomosis was onto the dorsalis pedis artery or distal anterior artery. Three grafts remain patent with successful limb salvage and ABI's greater than 1.0. Angioplasty is also useful for distal disease progression following femoro-popliteal bypass. Six patients with "at-risk" grafts underwent 8 tibial angioplasties for stenotic lesions in distal run-off. Radiologically, 6 procedures were successful with a median increase in ABI of 0.21 [range: 0.00-0.38] at a median follow-up of 7 months. There were less favourable results when a "graft-distal" bypass performed to salvage an occluded femoro-popliteal graft with diseased run-off vessels. Three of 4 grafts reoccluded within 3 months, 2 patients requiring amputation. We advocate an aggressive policy towards localised distal disease causing foot ischaemia.
Authors:
Y G Wilson; M G Wyatt; I C Currie; C J Wakeley; P M Lamont; R N Baird
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Panminerva medica     Volume:  38     ISSN:  0031-0808     ISO Abbreviation:  Panminerva Med     Publication Date:  1996 Jun 
Date Detail:
Created Date:  1997-02-19     Completed Date:  1997-02-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0421110     Medline TA:  Panminerva Med     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  71-7     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, Bristol Royal Infirmary, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angioplasty*
Female
Humans
Male
Middle Aged
Popliteal Artery / transplantation*
Tibia / blood supply*
Treatment Outcome
Vascular Diseases / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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