Limb salvage and quality-of-life after tibial and pedal endovascular revascularization

Chronic limb-threatening ischemia (CLTI) frequently demands infrapopliteal endovascular treatment to avert the loss of a limb and to improve functional results. The current study assessed the six-month limb salvage and quality of life following tibial and pedal endovascular procedures. Fifty patients with Rutherford classification 4 to 6 CLTI underwent tibial/pedal angioplasty. The primary outcome measure was six-month freedom from major amputation. Secondary outcomes measured the rates of intervention, minor amputation, and rates of complications, along with change in ankle brachial index and quality-of-life scores according to Stark QoL assessment at 1, 3, and 6 months. The standardized post-procedure antiplatelet regimen was followed. Overall success rate was 88%. Pedal access was employed in 35% of patients. Reinterventions were done in 10%, 12%, and 15% at the end of 1, 3, and 6 months, respectively. Amputations, both major and minor, were low (3% to 6% and 8% to 12%, respectively), but six-month survival rates reached 95%. ABIs significantly rose from 0.45 ± 0.12 to 0.72 ± 0.14 (p<0.0001), and the Stark QoL score rose from 45 ± 12 to 63 ± 11 (p<0.001). Tibial and pedal endovascular revascularization offers excellent limb salvage rates and significant clinical improvement for patients with CLTI. The substantial increase in perfusion and quality-of-life improvement attests to the therapeutic efficacy of infrapopliteal endovascular interventions.