[Transluminal angioplasty in a surgical setting. 150 cases].
Since 1985, 150 transluminal angioplasty operations have been performed by surgical teams, in the operating theater, for treatment of atheromatous lesions of the lower extremities, either as a complement to or in replacement of direct surgical repair. 150 angioplasties were carried out on patients with severe stage II lesions (72%). There was one or several significant stenosis in 140 of cases, and one short segmental thrombosis in 10 cases (1 common iliac and 9 superficial femoral or popliteal). These angioplasties fell into the following categories: 60 iliac, 78 femoral-popliteal and 12 angioplastic repairs of stenosis to iliac or distal femoral surgery (anastomosis, grafting, endarterectomy...). Angioplasty was combined with revascularization or lumbar sympathectomy in 29% of cases. It was performed singly in most cases (71%) and carried out percutaneously (45%) or by limited superficial proximal femoral approach under local anesthesia (26%), either directly or when the percutaneous approach failed. Eight cases of thrombosis (5.3%) developed during the first month: 2 cases after iliac angioplasty and 6 cases after femoral-popliteal angioplasty. Five deaths occurred consecutively to myocardial infarction. At long term, 4 cases of iliac thrombosis and 3 cases of thrombosis complicating femoral-popliteal angioplasty were detected. The overall cumulative permeability rate was 89% at 30 months, and there was no significant difference at one year's time between iliac and femoral-popliteal angioplasty patients (90% and 86%, respectively). Data collected from digital angiographic monitoring allowed to detect 9 cases of residual or recurrent stenosis (2 iliac, 6 femoral-popliteal and 1 postoperative lesions). Two repeat femoral-popliteal angioplasties were successfully performed.(ABSTRACT TRUNCATED AT 250 WORDS)
Clément
C
C
Service de Chirurgie Vasculaire, Hôpital Robert-Debré, Reims.
Costa-Foru
B
B
Vernon
P
P
Nicaise
H
H
D000800:Angioplasty, Balloon / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000601:surgery* / Q000628:therapy; D003251:Constriction, Pathologic / Q000601:surgery / Q000628:therapy; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D007430:Intraoperative Care; D007511:Ischemia / Q000601:surgery / Q000628:therapy; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery; D012008:Recurrence
Angioplastie transluminale en milieu chirurgical. 150 cas.