Abstract
Clinical outcomes of patients with critical limbs ischemia（CLI）are unfavorable. Arterial revascularization is necessary for limb salvage. Bypass surgery（BS）is the standard arterial revascularization method, but CLI patients rarely qualify as surgical candidates because of their poor clinical background, such as frailty, concomitant disease and advanced age. Therefore, less-invasive percutaneous endovascular therapy（EVT）has become popular. For limb salvage, EVT was demonstrated as sufficient and the objective performance goal was met（84% limb salvage rate at 1 year）. However, regarding wound healing, EVT still presents clinical challenges. According to recent clinical trials, approximately 20% of patients who underwent EVT had unhealed wounds, even though major amputation was successfully avoided. This percentage is larger than that after BS. Therefore, EVT needs to be improved to increase the rate of wound healing. Several clinical trials have reported that below-the-ankle（BTA）diseases result in poorer clinical outcomes, especially regarding wound healing. Thus, adjunctive EVT for BTA diseases may improve wound healing. We previously reported the clinical efficacy of BTA angioplasty in single center and multicenter trials. In this report, we summarized the results of EVT for BTA diseases.
