Chin, Leong Yung
(2017)
Evaluation of clinical outcome post lower limb angioplasty in peripheral arterial disease patient.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction
Peripheral arterial disease is caused by atherosclerosis or thromboembolic processes that alter
the structure and function of the arteries of the lower extremity. Most of the patients presented
to medical personnel after they experience claudication, non-healing wound, or foot gangrene
which increases the risk of amputation. The aim of treatment in PAD with its complication is
to maintain the vascular patency and preserve a functional limb. Lower limb angioplasty
service was started since year 2012 in this centre and referral were received from various unit
in this facility (vascular, orthopaedics, plastic etc.) and other nearer health centers. The purpose
of this study was to evaluate the safety and efficacy of lower limb angioplasty procedure in
term of lower limb salvage.
Objective
The main objective of this study was to evaluate the safety and efficacy of lower limb
angioplasty in treating peripheral arterial disease patients at intervals of 6months and 1-year
interval. Clinical outcome was based on successful limb salvage where patients able to preserve
talus and calcaneus after amputation at the Chopart level or distal to it. In addition, this study
will help to identify the factors for successful limb salvage.
Methods
35 patients (37 lower limbs) aged between 40 to 82 years old who had been treated with lower
limb angioplasty for peripheral arterial disease were selected from Advanced Minimally
Invasive Endovascular and Neurointerventional (AMIEN) Unit registry in Hospital Universiti
Sains Malaysia. The patients were identified according to the pre-determined inclusion and
exclusion criteria by using Hospital PACS system. All lower limb angioplasty was performed
by an interventional radiologist and the angiogram result prior to angioplasty was validated.
Angiogram films were studied when the data provided in the previous report were insufficient.
6 months and 1-year clinical outcome of angioplasty was accessed by tracing the patient folder.
The data were diligently collected and were analysed using the IBM® Social Science and
Statistical Packaged (SPSS) software.
Results and conclusion
The technical success rate for lower limb angioplasty in this centre was 89%, however, the
limb salvage rate at 6 months and 12 months was only 67.5%. This study had shown that the
technical success of lower limb angioplasty does not equal to successful limb salvage. Lower
limb angioplasty was considered a safe and efficient procedure with minimal complication
and low technical failure rate. The study failed to demonstrate the factors that influence the
clinical outcome of lower limb angioplasty. An extensive study involving larger samples
from various regions in the country is recommended for a more conclusive and representative
data for our Malaysian populations.
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