Percutaneous transluminal laser angioplasty versus balloon dilation for treatment of popliteal artery occlusions.
OBJECTIVE
To compare the immediate results, complication rates, and long-term outcomes of percutaneous transluminal laser angioplasty (PTLA) versus balloon dilation alone in the treatment of popliteal artery occlusions.


METHODS
In a prospective nonrandomized study conducted between December 1994 and June 2000, 215 symptomatic patients with unilateral popliteal occlusions were treated with either dilation alone (88 patients: 52 men; mean age 62 years, range 48-83) or PTLA (127 patients: 70 men; mean age 64 years, range 49-86) using a 308-nm excimer laser followed by dilation. The average occlusion length was 10.4 cm (range 3-14).


RESULTS
PTLA was successful in recanalizing 105 (82.7%) arteries, while the recanalization rate for dilation alone was only 70.4% (62/88; p=0.045). After a mean follow-up of 36 months (range 6-52), the primary and secondary patency rates were 21.7% and 50.8%, respectively, in patients with PTLA and 16.3% and 35.2% in the angioplasty group (p=0.762). The complication rates associated with both techniques were similar.


CONCLUSIONS
Although initial recanalization may be better with PTLA, it does not appear to add any long-term benefit over balloon dilation alone.
Steinkamp
Hermann J
HJ
Department of Radiology, Campus Virchow Klinikum, Humboldt University, Berlin, Germany. hermann.steinkamp@charite.de
Rademaker
Jürgen
J
Wissgott
Christian
C
Scheinert
Dierk
D
Werk
Michael
M
Settmacher
Utz
U
Felix
Roland
R
D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D017222:Angioplasty, Balloon, Laser-Assisted; D001157:Arterial Occlusive Diseases / Q000503:physiopathology / Q000628:therapy*; D002404:Catheterization; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D011446:Prospective Studies; D011859:Radiography; D012008:Recurrence; D012086:Reoperation; D013995:Time; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator