Pedal Artery Angioplasty: Beneficial or Just Cosmetic?

The key goal of treatment for critical limb threatening ischaemia (CLTI) is amputation prevention and limb salvage in the long term. Therefore, there is a need to look beyond the initial (technical) success of endovascular procedures and to also take into account the effect on wound healing in the long term. In this issue, Yanagiuchi et al. report on the effect of pedal artery angioplasty (PAA) on wound recurrence in the long term and come to an important, and surprising, conclusion, showing a significantly higher wound recurrence rate often with deterioration of plantar arch artery morphology after PAA than after a non-PAA treatment in patients with CLTI (thus not only influencing outcomes, but also making re-intervention more challenging).