In the management of patients with peripheral arterial occlusive disease the length and location of an arterial occlusion has an impact on the choice of the method of arterial reconstruction, i.e. percutaneous transluminal angioplasty or vascular surgery. The aim of this study was to determine the accuracy of colour-coded Doppler sonography (CDS) compared to conventional contrast arteriography in detecting the length and localisation of an occlusion in peripheral arteries. 100 legs of 94 patients (27 women, 44 to 82 years of age [mean 60.9 years] and 67 men, 21 to 78 years of age [mean 61.3 years]) with clinically suspected artery occlusion were examined prospectively with CDS before angiography and angioplasty. The exact localisation was correctly diagnosed by CDS in 95% with a high correlation (r = 0.95) of occlusion length between both methods. The sensitivity in detecting occlusions was 98% (positive predictive value 98%). It is concluded that colour-coded Doppler sonography can diagnose the length and location of an occlusion in peripheral arteries accurately and therefore can be used as a noninvasive method to select patients for further therapy management.

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75 patients with difficult occlusions in the superficial and popliteal arteries were treated by the "Rotacs" system. This technique is efficient in treating occlusions longer than 10 cm, with an initial success rate of 60.5%. In primary failed conventional angioplasties Rotacs-PTA was successfully employed in 56% as a second intervention. This is considered to be an advance in PTA technique. In stage II disease the PTA results are better than in diseases of the stages III and IV, which agrees with conventional catheter treatment. In the femoropopliteal overlapping segment the initial successful PTA of short, hard, mostly calcified occlusions was only 33%. The complication rate of Rotacs technique compares with that of the conventional methods.