الفهرس 
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Abstract
This study aims to assess the role of infrapopliteal angioplasty (PTA) as an important tool for limb salvage in patients with critical limb ischemia.
Infrapopliteal angioplasty has been increasingly applied to patients with critical limb ischaemia ( ischemic rest pain, ulcers,&/or gangrene).
Patients with CLI are typically elderly with multiple co-morbidities and the typical pattern of disease includes multiple stenosis and occlusions in the arterial tree from the superficial femoral artery (SFA) to the pedal arch . However, in 25% of patients with CLI, the lesions are Confined to the infrapopliteal arterial territory .
This study was done on 10 patients for whom PTA was performed for infrapopliteal occlusive disease with CLI (7 patients (70%) with rest pain, 2 patients (20%) with ulcer,3 patients (30%) with gangrene).
Pre-procedural vascular imaging was done in the form of CT angiography or duplex arterial mapping.
Five patients (50%) with isolated infrapopliteal arterial disease and 5 patients (50%) with multilevel disease.
Angioplasty was performed in 2 superficial femoral arteries (20%), 5 popliteal arteries (50%), 5 anterior tibial arteries(50%) , 5 posterior tibial arteries(50%) and 1 peroneal arteries (10%).
We followed up the cases for six months after the procedure.
Outcome was 6 months primary patency rate (90%) and secondary patency rate (80%), clinical improvement (90%) and limb salvage (90%)
We concluded that Ankle-Brachial Index (ABI) was a good index and investigation and ABI (≥0.8) within the first three months post procedure was correlated with a better outcome and ABI increased( > 0.1) but not reach 0.8 showed detorioration of symptoms.
The advantages of angioplasty rather than surgery are obvious, especially with high surgical risk patients because of multiple co-morbidities such as diabetes, heart disease and renal disease: angioplasty is safer, less-invasive, less traumatic, lower morbidity and mortality, shorter hospital stay, no need for general anesthesia, may be repeated as necessary and does not preclude surgery.
The results of this study on the short-term outcome of angioplasty suggest that Infrapopliteal angioplasty showed very acceptable clinical outcomes in terms of primary patency , limb salvage and survival.
So angioplasty should be considered as the first line of treatment in the management of infra-popliteal arterial disease especially with high surgical risk patients.