الفهرس 
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Abstract
Peripheral arterial disease (PAD) is a progressive chronic debilitating disease which is prevalent in diabetic elder people. Critical limb ischaemia (CLI) is severe form of PAD with a high risk of major amputation, disability and death.
Moreover, the relative high mortality and morbidity, which associated with short distal bypass surgery, led interventionist to invest in and develop endovascular treatment in these patients. Interventionists had overcome arterial spasm by usage of thin guide wires (0.014 and 0.018 inch guide wires) and intraarterial administration of nitroglycerin.
They also lessened the percentage of dissection by long balloons (12 up to 20 cm in length) with low profile (2 mm in diameter). But till now the restenosis is considered as valuable obstacle for angioplasty, however the newly developed drug eluting balloons are showing promising results by better patency rates.
Our study included 30 patients with critical limb ischaemia for whom percutaneous transluminal angioplasty was done.
The plan was that in all patients with gangrene or severe infection we try to revascularize as much tibial vessels as possible. For every patient, the following data were recorded: indications of the procedure, risk factors i.e. diabetic, cardiac, hypertensive and renal failure, indication for stenting if needed, size of the stent.
The study included: all patients were treated by balloon angioplasty. The primary patency rates for treated patients by ballooning or stenting were 100% in both 1 month and 6 months follow up. Limb salvage rate was 100% in 6 months follow up.
Endovascular therapy is still considered as a first-line of treatment options for patients suffering from critical limb ischemia with popliteal and infrapopliteal arterial occlusive disease by easily revascularizing inflow and outflow lesions with minimal morbidity and mortality. It has the ability to significantly improve distal extremity perfusion pressure with high technical success rates. We recommend the use of the drug eluting balloon in all tibial angioplasty.