Complications in percutaneous transluminal angioplasty: relationships with patient age

Abstract

Five hundred consecutive attempted lower limb angioplasties for ischaemic disease (370 patients, mean age 65.6 years, range 33-91 years) were reviewed. Significant complications occurred in 44 cases (8.8%). Nine patients (1.8%) underwent emergency surgery related to a complication. A further 12 patients (2.4%) underwent elective surgery related to a complication. In addition, four patients died within 30 days of the procedure; one following surgery performed because of a complication of angioplasty, one following a myocardial infarction, one following severe bleeding associated with subsequent thrombolytic therapy and one during emergency surgery related to a complication of angioplasty. A correlation was found between complication rate and age. This relationship was independent of the approach to, the position of, and the severity of the treated lesion. Elderly patients are at increased risk of complication in lower limb angioplasty.

Techniques for the endovascular management of complications following lower limb percutaneous transluminal angioplasty

“…We suggest that this is because the majority of intraluminal angioplasties were performed for stenoses whereas the majority of subintimal angioplasties were performed for occlusions. 16 Overall, in the present series, 14% of limbs suffered an early complication, this is very much in keeping with published complication rates. It is important to note, however, that the majority of these complications (97%) were managed by endovascular techniques with surgery being required in only 0.5% of all patients.…”

Risks and benefits of femoropopliteal percutaneous balloon angioplasty

“…A previous multivariate analysis demonstrated an odds ratio for critical ischemia of 2.5 (95% CI 1.4 to 4.7) in predicting morbidity and 4.7 (95% CI 1.2 to 17.9) in predicting 30-day mortality rates. 6 Other studies have found indication and age to be significant risk factors for complications, z°, 21 The multivariate analysis presented here supports the hypothesis that the presence of critical ischemia and the patient's age significantly increase the risk of complications associated with angioplasty. The odds ratios for the presence of occlusion, hypertension, and diabetes mellitus indicate that these may be additional risk factors for complications; however, the sample size is too small to demonstrate statistical significance with control for indication and age.…”

Reprinted Article “Exercise Training Versus Angioplasty for Stable Claudication. Long and Medium Term Results of a Prospective, Randomised Trial”

“…Although the complication rate of PTA is low, nonetheless a small percentage (2%) of patients will require surgery to correct complications. 16 There are no complications of exercise training, nor does it compromise subsequent PTA or surgery should they be necessary. Exercise training has the additional merit of promoting a generalised feeling of well-being.…”