Should percutaneous transluminal angioplasty be recommended for treatment of infrageniculate popliteal artery or tibioperoneal trunk stenosis?
OBJECTIVE
The purpose of this study was to determine the effectiveness of percutaneous transluminal angioplasty (PTA) for treatment of patients with localized stenosis of the infrageniculate popliteal artery and tibio-peroneal trunk (IGPA).


METHODS
The records of 25 patients undergoing IGPA PTA from 1983 to 1993 were reviewed. Patients underwent follow-up with clinical examinations, ankle-brachial indexes, Duplex scanning, and arteriography. Demographic variables and cardiovascular risk factors were analyzed and correlated with outcome.


RESULTS
Mean follow-up was 44 months. With life-table analysis, clinical and hemodynamic success was 59%, 32%, and 20% at 1, 2, and 3 years, respectively. Average time to recurrence was 17 months. Sixteen patients required a subsequent procedure; two had only repeat PTA, six had repeat PTA followed by arterial bypass, and eight had bypass alone. The mean additional benefit of repeat PTA was 8 months. Eleven of the 14 patients treated with bypass became symptom-free with patent grafts at a mean follow-up of 52 months. No risk factor was statistically significant in predicting success of IGPA PTA.


CONCLUSIONS
IGPA PTA is an expensive temporizing measure with a high rate of recurrence requiring subsequent intervention. The procedure should be restricted to patients with limited life expectancy or contraindications to operation.
Treiman
G S
GS
Division of Vascular Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Treiman
R L
RL
Ichikawa
L
L
Van Allan
R
R
D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000098:blood supply*; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery; D011859:Radiography; D012008:Recurrence; D016909:Tibial Arteries; D016896:Treatment Outcome; D014463:Ultrasonography