title: Percutaneous transluminal angioplasty in 226 iliac artery stenoses: role of the superficial femoral artery for clinical success.
abstract: We reviewed the results of 174 consecutive percutaneous transluminal angioplasties (PTA) for 226 iliac artery stenoses (mean length 1.6 cm, range 0.2-9.6 cm) in 150 patients with lower limb ischaemia. Vascular intervention was indicated by intermittent claudication in 123 and critical ischaemia in 51 (29%) limbs. There were 12 (7%) failed guide-wire recanalizations. Four (2%) serious complications from puncture site haemorrhages or peripheral embolizations were handed surgically and caused one major amputation. Five-year patency in 162 successful dilatations was 68% primarily and 81% secondary to vascular surgical reconstructions during an average 28 (range 1-60) months of observation. One hundred and thirteen (70%) limbs improved clinically. In 95 limbs treated exclusively by iliac PTA, clinical improvement was achieved in 38/47 (81%) limbs with patency and 24/48 (50%) limbs with occlusion of the superficial femoral artery (SFA) (p < 0.003), whereas vascular patency of iliac PTA was unaffected by status of the SFA. Five-year limb salvage rate was 50% in limbs with critical ischaemia. We conclude that PTA for iliac artery stenoses is a low-risk procedure offering acceptable clinical results provided the SFA is patent. As an adjunct to distal bypass surgery, iliac PTA improves inflow without the requirement for major aorto-iliac surgery and may extend indications for vascular intervention in patients with lower limb ischaemia.
authors: Department L of Vascular Surgery, Bispebjerg Hospital, University of Copenhagen, Denmark.
authors: B
authors: B
authors: Jørgensen
authors: N
authors: N
authors: Skovgaard
authors: J
authors: J
authors: Nørgård
authors: A
authors: A
authors: Karle
authors: P
authors: P
authors: Holstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery; D007383:Intermittent Claudication / Q000628:therapy*; D007511:Ischemia / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D014654:Vascular Patency / Q000502:physiology