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OBJECTIVES: Cryoballoon angioplasty in conjunction with thrombolysis and laser atherectomy is a safe and effective treatment for critical limb ischemia in patients with peripheral arterial disease.
METHODS: From September 2004 to July 2009, 203 patients (50.25% males and 49.75% females) underwent 246 primary percutaneous lower extremity interventions. Average age was 70.58 ± 11.66 years, ranging from 38 to 96 years. The most common comorbidities were hypertension (88.67%), diabetes (64.53%), hyperlipidemia (58.62%), smoking (58.13%), and coronary artery disease (56.16%). Indications for surgery were limb threatening ischemia and severe claudication. TASC C lesions were present in 54.92% of cases and TASC D lesions were present in 45.08% of cases. Stenting was required in 93 cases (35.23%) and 142 cases (53.79%) involved cryoballoon angioplasty of the infrapopliteal vessels. We retrospectively analyzed the outcomes of 264 cases by evaluating technical success, clinical success and patency.
RESULTS: Technical success rate was 96.97% and clinical success rate was 84.44%. Within 30 days post op, 4.55% of cases required repeat percutaneous intervention and 3.79% required a leg amputation. Complications were present in 5.69% of surgeries. The most common complications were bleeding requiring transfusion (1.63%), hematoma requiring surgery (1.63%), renal insufficiency (0.81%) and myocardial infarction (0.81%). Survival and limb salvage rates within 30 days post op were 96.55% and 96.21% respectively. Patency, limb salvage and amputation free survival rates are listed in Table 1.
CONCLUSIONS: The combination of cryoballoon angioplasty, thrombolysis and laser atherectomy is safe and effective in treating TASC C and D lesions in this high-risk group of patients with critical limb ischemia.

Patency, limb salvage and amputation free survival rates

	3 Mo. (%)	6 Mo. (%)	9Mo. (%)	12 Mo. (%)	24 Mo. (%)
Primary Patency	82	64	57	56	39
Primary Assisted Patency	100	92	83	78	46
Secondary Patency	95	85	81	70	43
Limb Salvage Rate	94.70	92.42	90.91	89.77	88.64
Amputation Free Survival Rate	89.16	85.22	82.76	80.30	70.94