膝下动脉血运重建联合足底-足背弓腔内成形术治疗慢性肢体威胁性缺血合并 2 型足动脉弓

Objective To observe the effect of infrapopliteal arterial revascularization combined with pedal and plantar loop angioplasty (PPL) for treating chronic limb-threatening ischemia (CLTI) complicated with type 2 pedal arch. Methods Data of 238 CLTI complicated with type 2 pedal arch patients who underwent successfully infrapopliteal arterial revascularization were retrospectively analyzed, including 140 cases underwent simultaneously PPL (PPL group) but 98 cases did not (non-PPL group) during operation. The rate of cumulative wound healing and limb salvage at 1, 3, 6 and 12 months after operation were compared between groups. Results During follow-up, amputations occurred in 2 cases and 8 cases died (including 1 case of amputation) in PPL group, and the rate of limb salvage was 93.57% (131/140) at 12 months after operation. In non-PPL group, amputations occurred in 11 cases and 8 cases died (including 3 cases of amputation), with the rate of limb salvage of 83.67% (82/98) at 12 months after operation. The limb salvage rates at 12 months after operation were significantly different between groups (χ²=6.008, P=0.014). The cumulative wound healing rate of PPL group was 12.86% (18/140), 47.14% (66/140), 70.00% (98/140) and 85.71% (120/140) at 1, 3, 6 and 12 months after operation, respectively, while of non-PPL groups was 7.14% (7/98), 37.76% (37/98), 51.02% (50/98) and 78.57% (77/98), respectively. The cumulative wound healing rate of PPL group was higher than that of non-PPL group at 6 months after operation (P<0.05), but not at 1, 3 and 12 months after operation (all P>0.05). Conclusion Infrapopliteal arterial revascularization combined with PPL was valuable for treating CLTI complicated with type 2 pedal arch, which could improve wound healing rate and limb salvage rate to a certain extent.