الفهرس 
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Abstract
ritical limb ischemia (CLI) occurs due to progressive obstructive nature of atherosclerosis disease. Nowadays, there is widespread use
of endovascular revascularization procedures for restoration of blood flow in CLI.
The aim this study is evaluation of the efficacy of endovascular intervention in patients with critical limb ischemia.
This prospective study was included 40 patients presenting with chronic atherosclerotic critical lower limb ischemia to the department of vascular surgery, in Beni Suef University Hospital and Al-Agouza Police hospitals, during the period of October 2017 till April 2019. Study end points were limb salvage and wound healing.
Inclusion criteria:
• Patient aged 18 years or more.
• Patients with critical limb ischemia.
• Patient willing to comply with the specified follow-up evaluations at the specified times.
• Patient (with his or her legal representative) understands the nature of the procedure and provides written informed consent.
Exclusion criteria:
• Patients presenting with severe tissue loss or whole foot lost.
• Patients presenting with gangrene of the heel.
• Patients presenting with ejection fraction less than 35%.
• Patients presenting with renal impairment or orthopnea.
Detailed of the procedure, its indications, methods, risks, and outcome were explained for every patient. After which, written informed
consent was obtained from all patients or their legally authorized representatives. This study approved by the institutional review board or ethics committee of Beni Seuf University Hospital and Al-Agouza Police Hospital as well as it is conducted in accordance with International Conference on Harmonisation guidelines and other applicable laws and regulations.
Endovascular treatment was the first choice modality of treatment in revascularization of all patients.
All endovascular procedures were done under local anesthesia.
The outcome was evaluated for every case immediately postprocedure, 3, and 6, 12 months later. Immediate evaluation based on clinical assessment (pulse, capillary refill, and warmth) and angiography. Follow-up by clinical reassessment and duplex was done.
Statistical analysis of our results revealed the following:
• The mean age was 60.65 years with a SD of 10.8 years.
• The studied cases were 26 males and 14 females with a male: female ratio near to 2:1.
• Two-thirds (23) of the cases suffered from systemic hypertension. The majority (80%) were diabetics. chronic Arterial Disease (CAD) was detected in 10 cases (25%) and chronic Heart failure (CHF) was in 5 cases (12.5%). Only two cases suffered from COPD. Eight cases had renal insufficiency with only 2 cases of renal dialysis.
• According to Rutherford classification for chronic lower limb ischemia, 30 (75%) patients presented with rest pain, while 24 (60%) with ulcer and 16 (40%) patients suffered from tissue loss.
• 15 cases (37.5%) had one artery treated, 13 cases (32.5%) had 2 arteries treated and 12 cases (30%) had 3 arteries treated.
• Out of studied 40 cases only 7 cases had technical failure while the majority of cases - (33 cases) 82.5% - Successfully passed.
• No detected relation between chronic medication use and technical failure among the studied cases; p-values >0.05.
• Technical failure was significantly higher among cases suffered from hypertension, chronic heart disease and chronic obstructive lung disease.
• The presence of diabetes has not been found to be statistically significant in relation to technical failure and limb salvage (p value= 0.108).
• Lower mortality rate (2.5%) among enrolled patients.