Combined iliac transluminal angioplasty and femoropopliteal reconstruction for multilevel arterial occlusive disease.
Patients with multilevel arterial disease represent a challenging problem. A retrospective review of 46 consecutive femoropopliteal reconstructions combined with iliac balloon angioplasty was performed. Twenty-five procedures were below-knee and 21 to the above-knee popliteal artery segment. Mean follow-up was 26.8 months (range 4 to 84). There were 2 peroperative deaths and 3 serious complications (10.9%). In the late follow-up 4 significant restenoses and 1 reocclusion occurred for a patency rate of 81% for the inflow procedure at 5 years. Primary and secondary patency rate of combined procedures at 5 years was 61% and 76% respectively. The 5-year limb salvage rate was 93%. The mortality rate, morbidity rate and cumulative patency were not significantly different from a group of 38 patients who underwent 43 aortofemoral bypasses combined with femoropopliteal revascularization. In the latter group, the frequent incidence of anastomotic aneurysm (9.2%) was the main detrimental factor observed at follow-up. The authors conclude that femoropopliteal reconstruction combined with iliac angioplasty is effective for managing patients with multilevel disease. The possibility of intraoperative digital subtraction angioplasty and the use of no-profile co-axial balloon catheter design in the latter years of this study has improved our results.
Bull
P G
PG
Department of Surgery, Wilhelminenspital, Vienna, Austria.
Schlegl
A
A
Mendel
H
H
D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000453:epidemiology / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D003131:Combined Modality Therapy; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000453:epidemiology; D006801:Humans; D007083:Iliac Artery; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D014654:Vascular Patency / Q000502:physiology