Foot salvage angioplasty

Foot salvage angioplasty is a procedure that aims to restore blood flow to the foot and prevent amputation in patients with critical limb ischemia, a condition where the arteries in the legs are severely narrowed or blocked by plaque. Foot salvage angioplasty involves inserting a thin tube called a catheter into the affected artery and inflating a balloon at its tip to widen the artery and improve blood flow. Sometimes, a small metal mesh tube called a stent is also placed inside the artery to keep it open1.

Foot salvage angioplasty can be performed on different arteries in the foot, depending on the location and extent of the blockage. One of the concepts that guides the selection of the target artery is the angiosome concept, which divides the foot into different regions based on their blood supply from specific source arteries2. According to this concept, it may be more effective to perform angioplasty on the artery that directly supplies blood to the affected region of the foot, rather than on an artery that supplies blood indirectly through collateral vessels2.
However, foot salvage angioplasty is not without challenges and risks. The arteries in the foot are very small and tortuous, making them difficult to access and treat. The procedure may also cause complications such as bleeding, infection, vessel damage, or restenosis (re-narrowing of the artery). Moreover, the biomechanics of the foot may affect the durability and integrity of the stents placed in the foot arteries, as they may be subjected to repeated bending, twisting, and compression during normal foot movements2.
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Therefore, foot salvage angioplasty should be performed by experienced operators who are familiar with the anatomy and biomechanics of the foot, and who can select the appropriate technique and device for each case. Foot salvage angioplasty should also be combined with other measures such as medication, wound care, lifestyle changes, and regular follow-up to ensure optimal outcomes and prevent further complications.

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