In 2019, the guide "Chronic Limb-Threating Ischemia" was published by the Society European Vascular Surgery (ESVS). In this guide, the GLASS scale was introduced. GLASS Is sought as an anatomical scale and a tool to predict the success rate of endovascular procedures. Regarding infrapopliteal sector, GLASS takes into account the tibial arteries exclusively. Thus, in case of extensive disease of these arteries, the patient would correspond to GLASS III, which translates into a possibility of technical failure of more than 20% and a permeability in the first year of less than 50%. It is shocking to see that no mention of peroneal artery was done in this scale. In our experience, peroneal artery contributes directly to the salvage of the limb in many cases.

In this work we try, in some way, to "quantify" the weight of the peroneal artery in limb prognosis and identify anatomical features that help improve it. We made a single-center retrospective observational study was conducted between 2015 and 2020. In this period, all periferial angiographies done in patients with lower limb arterial disease have been taken into account. As an inclusion criterion, we have introduced all the extremities that presented a peroneal artery as a single patent artery. Details about anatomical aspects of the peroneal artery were gathered and classified.

During this period, 367 angiographies of the peripheral sector have been performed. Of which in 96 patients or 113 limbs, the peroneal artery was the only distal trunk of arrival to the foot. Of these limbs, 88% at 6 months or 82% at 12 months presented no amputation. In 69% of these cases, the peroneal artery was treated. At first year post-treatment, there have been 8 deaths and major amputations (9%).

We could conclude that the peroneal artery is an important vessel for limb salvage, therefore it should be considered in the different risk prediction classifications.