Percutaneous transluminal angioplasty without anticoagulation.
This paper presents the results of a retrospective study of 110 percutaneous transluminal angioplasties done over a period of two years on 110 consecutive patients. Anticoagulation or antiplatelet drugs were not used during or after percutaneous transluminal angioplasty. Life-table analysis was used to calculate success rates at one and three months following the procedure. Success rates were determined using three criteria: clinical improvement, pre- and post-percutaneous transluminal angioplasty Doppler studies, and radiographic appearance. Claudication was present in 87 (79%) patients and severe ischemia in 23 (21%) patients. Sixty-eight (62%) PCTAs were done in the iliac arteries, 35 (32%) in the femoral arteries, and 7 (6%) in the popliteal artery. The majority of patients (61%) had 50%-75% arterial stenosis and only 18% had complete occlusion. Percutaneous transluminal angioplasty in the iliac arteries had the best results with cumulative success rates of 90% and 85% at one and three months, respectively. Success rates in the femoral arteries were 83% and 79% and in the popliteal artery 71% and 57% at one and three months, respectively. None of our patients required amputation. Ten patients (9.1%) suffered the following complications within 30 days of percutaneous transluminal angioplasty: death (2), thrombosis (2), perforation (3), minor hematoma (2), and false aneurysm (1). In conclusion, we have shown that percutaneous transluminal angioplasty can be performed safely and effectively without the use of anticoagulation and its associated risks.
Ameli
F M
FM
Division of Vascular Surgery, Wellesley Hospital, University of Toronto, Ontario, Canada.
Stein
M
M
Provan
J L
JL
St Louis
E L
EL
Legrand
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000379:methods*; D000925:Anticoagulants / Q000627:therapeutic use*; D005069:Evaluation Studies as Topic; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014652:Vascular Diseases / Q000628:therapy*
D000925:Anticoagulants; D006493:Heparin