Long-term outcome of infrainguinal percutaneous transluminal angioplasty.
OBJECTIVE
To evaluate the long-term outcome of infrainguinal percutaneous transluminal angioplasty (PTA).


METHODS
Between 1991 and 1994, 77 patients (45 men; mean age 70 years, range 41-85) underwent infrainguinal PTA for occlusive disease. Patient records and angiographic examinations were reviewed to extract data to a patient register. A long-term (mean 9.3 years) follow-up examination of survivors was performed, including physical evaluation, walking impairment questionnaire (WIQ), and duplex ultrasound.


RESULTS
Cumulative primary and secondary patency rates, respectively, were 81% and 86% at 1 year, 65% and 73% at 5 years, and 12% and 17% at 10 years. Patency rates were better for patients with claudication than critical ischemia (p=0.02). Stenoses had better primary patency than occlusions (p=0.001), but there was no difference between stenoses <2 cm versus >/=2 cm. At long-term follow-up, patients with patent vessels (50%) had better ankle-brachial indices (p=0.01) and less pain in their calves (p=0.04) compared to patients with non-patent vessels, but there was no difference in walking capacity or quality of life. Generalized femoral artery disease (p=0.03) and diabetes mellitus (p=0.03) predicted poor survival.


CONCLUSIONS
Although the overall long-term patency of infrainguinal PTA is poor, the technique has a low morbidity and can be performed in selected patients with a reasonable long-term result.
Wahlgren
Carl-Magnus
CM
Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden. carl-magnus.wahlgren@ks.se
Kalin
Bo
B
Lund
Kent
K
Swedenborg
Jesper
J
Takolander
Rabbe
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000401:mortality / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000401:mortality / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000401:mortality / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis