Femoropopliteal angioplasty: in hospital and follow-up results

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Abstract

Objective

To evaluate the short and long term outcome of the percuta-neous transluminal angioplasty (PTA) in the femoropoplitealarterial territory, in a group of symptomatic patients withperipheral arterial disease.

Material and methods

We evaluated ninety-eight consecutive angioplasties in 83patients, with a mean age of 69.8±9.9 years (27-86), and 52males. Fifty five procedures were done in patients with in-termittent claudication (123±80 meters) and 43 for criticallimb ischemia (rest pain or tissue loss). Evaluation includedclinical assessment, ankle-brachial index (ABI) before andafter the procedure and diagnostic angiography. The meanfollow-up was 17.7±12 months (1-53) through reviewingclinical records, ambulatory control or telephone contact.Reintervention was decided for recurrence of symptoms orsignificant reduction in ABI (> 0,2).

Results

Angioplasty was successful in 82 of 98 limbs (83%), with 16initial failures (17%).The mean ABI before PTA was 0.53±0.15 and after the pro-cedure was 0.82±0.22 (p<0,00000001). There were clinicalimprovement in 50 of 55 claudicant patients (91%), and in18 of 34 p with critical ischemia. Limb salvage rate was 68%in cases of limb-threatening ischemia, with a total of 21 am-putations in the follow-up (21.5%).The restenosis rate in the long term follow-up was 25% (21of 82 initially successfull procedures), and the all cause mor-tality rate was 17%. Due to PTA failure or restenosis 13 pa-tients underwent revascularization with bypass surgery.

Conclusions

Utilization of new endovascular techniques along with bal-loon angioplasty, and better diagnosis of the underlyingmechanisms of vascular ischemia in femoropopliteal disease,leads to good immediate and long-term outcome even in highrisk patients with limb threatening ischemia