Objective: To investigate the efficacy of TcPO2 and ankle-brachial index [ABI] as predictors of limb salvage outcomes in patients treated with drug-eluting stent [DES] for below-the-knee CLI.

Materials and Methods: This retrospective study was conducted in patients treated for CLI with below-the-knee [BTK] percutaneous transluminal angioplasty [PTA] with DES placement between January 2007 and June 2015 study period. The primary endpoints were pre- and post-procedural ABI and TcPO2. The secondary endpoints were limb salvage rate, time-to-major amputation, and ulcer healing.

Results: Seventy-two patients (79 limbs) were included. Of those, 40 were men and 39 were women, and the mean age was 73.8±8.0 years. The median follow-up time was 349 days and the 1-year limb salvage rate was 95%. Complete wound healing at one year was observed in 76% of patients. Overall ABI was significantly improved from 0.70±0.17 to 0.89±0.26 (p<0.001). In isolated below-the-knee DES patients, ABI was significantly improved from 0.74±0.18 to 0.99±0.25 (p = 0.019), and TcPO2 was significantly improved from 17.50±9.62 to 35.50±11.84 mmHg (p = 0.035).

Conclusion: Long-term outcome of DES placement at BTK level was associated with high limb salvage rate and wound healing, as evidenced by increased ABI and TcPO2.

Keywords: Below-the-knee critical limb ischemia, Drug-eluting stent, Transcutaneous oxygen tension, Wound healing