Clinical Value Of Pedal And Plantar Loop Angioplasty For The Type 2 Pedal Arch Ischemic Foot

Objective: To evaluated the clinical effect of pedal and plantar loop angioplasty for the type 2 pedal arch ischemic footMethods: We performed a retrospective analysis of data gathered from 42 cases of type 2 pedal arch ischemic foot.24 pedal and plantar loop angioplasties were performed(Group A),while 18 pedal or plantar arch angioplasties were performed(Group B).The curative effects of angioplasty were assessed by postoperative wound healing performed every 3 months during clinical follow-up visits conduct ed to assess healing of the ischemic wound and The degree of ischemic symptoms.Events of amputation and death were recorded.Results: All 42 patients were successfully revascularized without complications,and during a mean follow up period of 1 to 3 months.The Ischemic symptoms remission rates at 3 months in the group A and group B(Rutherford 3)are 100%(10/10)VS 75%(3/4)respectively(P=0.286).The Ischemic symptoms remission rates at 3 months in the group A and group B(Rutherford 4)are 100%(4/4)VS 66.7%(2/3),respectively(P=0.429).The rate of Limb healing at 1 months in the group A and group B(Rutherford 5-6)are 40%(4/10)VS 9.1%(1/11)respectively(P=0.126);The rate of Limb salvage are 100%(10/10)VS 90.9%(10/11)respectively(P=0.563).The rate of Limb healing at 3 months in the group A and group B(Rutherford 5-6)are 80%(8/10)VS 27.3%(3/11),respectively(P=0.023);The rate of Limb salvage are 100%(10/10)VS 90.9%(10/11),respectively(P=0.563).The rate of Limb healing at 1 months in the group A and group B(Rutherford 5-6)patients with Diabetes are,28.5%(2/7)VS 10%(1/10)respectively(P=0.36);The rate of Limb salvage are,100%(7/7)VS 100%(10/10)respectively.The rate of Limb healing at 3 months in the group A and grou p B(Rutherford 5-6)patients with Diabetes are 85.7%(6/7)VS 30%(3/10)res pectively(P=0.036);The rate of Limb salvage are,100%(7/7)VS 100%(10/10)respectively.Also patients with completed pedal and plantar Loop through the plantar arch of aortaopened retrograde approach other dorsal or plantar artery,surgical success rate of 100%.There are 5 cases in which patients with plantar arch reverse puncture angioplasty,including two cases of limb arteries completely opened plantar arch and 3 patients without plantar arch angioplasty.Conclusion: That the Pedal and Plantar Loop technique for severe lower limb is-chemia in patients with type 2 plantar arch,we can improve the healing rate in patients with high clinical value.For patients with diabetes mellitus and severe lower limb ischemia can also benefit from the technique.There is no significant effect PPL technology preserved rate of Limb salvage.Retrograde arterial puncture plantar arch can be used as an alternative when antegrade approach is failure.