Articles Vol. 67 No. CĐ3-NCKH 02/04/2026

EVALUATION OF WOUND HEALING OUTCOMES AFTER BELOW-THE-KNEE ENDOVASCULAR INTERVENTION IN PATIENTS WITH CHRONIC LIMB-THREATENING ISCHEMIA

Nguyen Duy Tan1,2,3,4, Lam Thao Cuong5,6,7,8
1 Faculty of Cardiovascular and Thoracic Surgery, Thong Nhat Hospital
2 Department of Cardiovascular and Thoracic Surgery, VNU-HCM, University of Health Sciences
3 Khoa Ngoại Tim mạch - Lồng ngực, Bệnh viện Thống Nhất
4 Bộ môn Ngoại tim - Mạch máu và Lồng ngực, Trường Đại học Khoa học Sức khỏe
5 Faculty of Thoracic and Vascular Surgery, University Medical Center Ho Chi Minh city
6 Department of Thoracic and Cardiovascular Surgery, School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh city
7 Khoa Lồng ngực - Mạch máu, Bệnh viện Đại học Y Dược thành phố Hồ Chí Minh
8 Bộ môn Phẫu thuật Lồng ngực - Tim mạch, Trường Y, Đại học Y Dược thành phố Hồ Chí Minh
DOI: 10.52163/yhc.v67iCD3.4712
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Keywords
Chronic limb-threatening ischemia (CLTI), endovascular intervention, below-the-knee lesions, wound healing.
Abstract

Objective: To describe lesion characteristics and evaluate wound healing outcomes after below-the-knee endovascular intervention in patients with chronic limb-threatening ischemia.

Methods: This retrospective descriptive case-series included 71 patients with chronic limb-threatening ischemia and ischemic ulcers who underwent below-the-knee endovascular intervention at Thong Nhat Hospital between January 2024 and December 2024.

Results: The average age of the patients was 75.6 ± 9.8 years, with a predominance of males (76.1%); diabetes mellitus was present in 53.5% of patients. The anterior tibial artery was the most frequently affected vessel, accounting for 39.4% of lesions in the small-ulcer group and 22.5% in the large-ulcer group. Patients with large ulcers had significantly higher rates of occlusion of all three below-the-knee arteries (12.7%) and pedal arch occlusion (26.8%) compared with those with small ulcers (p < 0.05). At 12-month follow-up, wound healing rates were 22.5% in patients with three-vessel below-the-knee revascularization, 29.6% in those with two-vessel revascularization, and 11.3% in patients with single-vessel revascularization.

Conclusion: Below-the-knee endovascular intervention is effective in promoting wound healing in patients with chronic limb-threatening ischemia. A multivessel revascularization strategy combined with restoration of the pedal arch is a key determinant of limb salvage.

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