Prospective observational study shows improved outcomes in limb ischemia with endovascular intervention vs. medical management.
Background and aim Peripheral arterial disease (PAD) of the lower limbs causes significant morbidity and risk of limb loss. Endovascular interventions such as angioplasty with stenting may improve outcomes, but comparative prospective data are limited. This study aimed to evaluate the benefit of endovascular intervention (angioplasty with thrombolysis and stenting) and medical management in critical limb ischemia. Materials and methods A prospective observational study was conducted in a tertiary center. Forty-two adult patients with infrainguinal PAD were prospectively enrolled during the study period and received either medical management (Group A; n = 22) or endovascular intervention involving angioplasty with catheter-guided thrombolysis and nitinol stenting (Group B; n = 20). Outcomes, including pain relief, wound healing, need for amputation, mortality, and quality of life (measured by SF-36 and EQ-5D), were assessed over six months. Results Pain relief was observed in 72.7% of patients in Group A vs. 85% of patients in Group B. Wound healing showed a significant advantage in the intervention group: among those who presented with wounds, 81.8% healed in Group B vs. 20% in Group A (p = 0.0046). Amputation rates were 18.2% in Group A vs. 5% in Group B, and mortality was 18.2% in Group A vs. 5% in Group B, although these differences were not statistically significant. Conclusions Angioplasty with thrombolysis and stenting in patients with infrainguinal PAD yielded significant improvement in wound healing and self-care, with trends toward lower amputation and mortality compared with medical management.
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Kaushik et al. (2026) studied this question.
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