VS21P ‘ANGIOPLASTY AND AMPUTATION’: FIFTY PERCENT REDUCTION OF LOWER LIMB AMPUTATION FOLLOWING INTRODUCTION OF ANGIOPLASTY IN A RURAL HOSPITAL OVER A TEN YEAR PERIOD

Purpose  To assess the benefit of primary angioplasty in acute and chronic PVD in a rural hospital in regards to limb Salvage, types of bypass & diabetes. Methodology  Over 521 lower limb angioplasties have been done at NWRH Mersey campus’ a small hospital catering for a population of 100 000 people, from January 1996 to Jan 2006. Personal audit, hospital records and theatre coding used to generate the data. Candidates for angioplasty, bypass surgery and amputation selected & consented first for angioplasty on the basis of their symptoms & ABI. First 5 years of this study showed 180 angioplasties and 37 major amputations, 13 Aorto‐ileo‐femoral and 107 Femoral bypasses but second 5 years shows 226 angioplasties and 21 amputations, 3 Aorto‐ileo‐femoral and 49 Femoral bypasses respectively. We do angioplasty for all the patients with significant lower limb ischaemia and symptomatic diabetic foot. Balloon angioplasty is our preferred option. People with poor renal reserve had angioplasty under ultrasound. Angioplasty definitely reduces grief and depression of limb loss in patients. Results•  Angioplasty has significantly reduced the bypass rate by 60%. •  There is proof of tangible benefit in regards to ulcer healing of diabetic feet. •  We agree with other big series on this matter to say ‘Angioplasty reduces the rate of major amputation’ at least by 41%.Conclusions•  Angioplasty has a clear role in the management of Acute and Chronic lower limb peripheral vascular disease and may ultimately see bypass surgery as a relic of the past.