Percutaneous Transluminal Angioplasty for Severe Lower Extremity Ischaemia

Abstract

Percutaneous transluminal angioplasty (PTA) was attempted on 70 occasions in 63 consecutive patients presenting with advanced ischacmia. The procedure was technically succcssful in 64 (91%) with hacmodynamic improvement in 39 (56%) and clinical improvement maintained at 6 months in 51 (73%). Follow‐up ranged from 6 months to 4 years and life‐table analysis showed 60% succcss at 1 year and 58% success at 2 years. Overall limbsalvage was 76%. Complications occurred in 6 (9%) and in one case this lead to amputation. The relationship of a number of associated factors to outcome was assessed. The presence of cardiac disease requiring treatment for failure or angina was a highly significant adverse factor (P < 0.001). Decreasing age and greater extent of disease were also significant adverse factors (P < 0.05). Therefore, because of its low morbidity and cost. PTA can be seen as a useful procedure in patients presenting with advanced peripheral vascular discase

Interventional Procedures in Peripheral Atherosclerotic Disease

“…We certainly agree with Dr Kaufman that symptomatology, the presence of ischemic skin changes, and severely decreased pulse pressures as demonstrated by Doppler recordings aid in the identification of patients who will best benefit from therapeutic procedures.We concur with Dr Kaufman about the use of percutaneous transluminal balloon angioplasty in the management of patients in a limb-salvage situation, as is documented in our initial references 1,2. However, at The Johns Hopkins Hospi¬ tal and in the Baltimore medical commu¬ nity, severe life-style-altering claudica¬ tion is considered an indication for a therapeutic procedure, be it by a percu¬ taneous transluminal route or by an op¬ erative bypass.…”

Clinical outcome and restenosis following percutaneous transluminal angioplasty for ischaemic rest pain or ulceration

“…These were not significantly different from those of the other 50 patients undergoing angioplasty for rest pain or ulceration in the unit over the study period. Twenty-three patients required PTA below the inguinal Median (range) length of stenosis (cm) 2 (1-12) 2 (1-2) Median (range) length of occlusion (cm) 7 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) 5 (2)(3)(4)(5)(6)(7)(8)(9)(10) Continuous run-off vessel to ankle 8 9 ligament and two had tibial vessel dilatation for rest pain. After angioplasty 17 patients had a continuous patent vessel from aorta to ankle.…”