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Subject Area

Surgery

Article Type

Original Study

Abstract

Objectives: To assess the outcomes of angioplasty as the primary treatment for total occlusion of the superficial femoral artery (SFA) in patients with CLI, focusing on clinical, hemodynamic, and radiological improvements. Background: Critical limb ischemia (CLI) is a severe manifestation of peripheral artery disease (PAD) associated with significant morbidity and mortality. Revascularization, particularly angioplasty, plays a crucial role in preserving limb function and improving outcomes in CLI patients. Methods: This prospective study included thirty patients diagnosed with CLI and SFA total occlusion who underwent angioplasty at Menoufia University and Shebin El-Kom Teaching Hospital between January 2023 and November 2023. Preoperative evaluations included demographic data, comorbidities, and imaging with duplex ultrasound and CT angiography. Post-procedural outcomes were evaluated for changes in clinical symptoms, hemodynamic parameters, and wound healing rates. Results: Following angioplasty, significant improvements were observed in clinical symptoms, with rest pain decreasing from 60% to 20%(P = 0.002) and wound healing rates increasing from 16.7% to 46.7%(P = 0.032). Hemodynamic parameters showed substantial enhancement, including an increase in ankle brachial index (ABI) from 0.21 to 0.82(P < 0.001) and a 50 mmHg rise in absolute highest ankle pressure (P = 0.002). CT angiography confirmed complete resolution of SFA occlusion in 80% of patients’ post-intervention. Conclusion: Angioplasty for SFA total occlusion in CLI patients resulted in significant improvements in clinical symptoms and hemodynamic parameters. These findings underscore the effectiveness of angioplasty as a primary intervention for CLI. Further research is needed to validate long-term outcomes and compare with alternative treatment strategies.

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