Below-the-Ankle Disease in Peripheral Artery Disease: Characteristics, Consequences and Prevalence. Review of Endovascular Revascularization

Below-the-ankle (BTA) disease is highly prevalent in peripheral artery disease (PAD), particularly in those with critical limb ischemia (CLI). Presence of foot artery disease is associated with numerous adverse outcomes, including technical failure after revascularization. BTA disease remains poorly understood and undertreated.

BTA disease is defined as the angiographic presence of atherosclerotic stenoses and/or occlusions in one or more foot arteries. The pedal artery, plantar arteries (common, medial and lateral) and the plantar arch are among the foot arteries affected.

This report reviews the characteristics, comorbidities, consequences and prevalence of BTA disease in PAD and CLI. BTA prevalence in CLI patients and limbs is estimated for the 2020-2040 period. Calculations are based on THE SAGE GROUP’s CLI estimates for the Rutherford 4-6 and 5-6 populations in combination with BTA percentage prevalence derived from the literature review.

Medial artery calcification (MAC) and thrombus are common in the pedal arteries. Both increase the difficulty of endovascular revascularization. The percentage of patients and limbs with MAC and thrombus in the BTA territory is estimated for 2020-2040. Separate estimates are provided for the Rutherford 4-6 and 5-6 populations.

The current and potential U.S. market for endovascular treatment of BTA disease is estimated for the 2020-2040 period.

All estimates are provided in 5-year increments.

Treatment of BTA disease is challenging for anatomic reasons. These challenges include small-diameter vessels, vessel tortuosity, MAC and variants in the pedal circulation. The lack of dedicated tools for this vascular territory adds to the problem. In addition, the small foot vessels are prone to spasm and dissection

The review of endovascular revascularization includes expert recommendations on when to intervene, treatment challenges, complications, vessel sizes, lesion types and current devices employed to treat BTA arteries.

Price: $6,200

To Purchase:
Call 404-520-6652 or
Contact: yost@thesagegroup.us