title: Duplex-guided balloon angioplasty of lower extremity arteries.
abstract: The conventional balloon angioplasty of infrainguinal arteries requires the use of fluoroscopy and injection of contrast material. We attempted to perform 360 balloon angioplasties of the superficial femoral (SFA) and/or popliteal arteries under duplex guidance in 274 patients to avoid the nephrotoxic effect of contrast and eliminate or minimize radiation exposure. Critical ischemia was the indication in 35% of cases and severe claudication in 65%. Infrapopliteal angioplasties of 80 arteries were attempted in 54 cases (15% of all cases) in order to improve the run-off after completion of femoral-popliteal angioplasties. For femoral-popliteal segment, overall technical success was 95% (342/360 cases). For infrapopliteal arteries, technical success was achieved in 77 of 80 cases, with an overall success rate of 96%. Twelve-month patency rates for TASC class A, B, C, and D lesions were 90%, 59%, 52%, and 46%, respectively. PAVF <100 mL/min was the most powerful predictor of 30-day and 6-month arterial thrombosis following femoral/popliteal balloon angioplasties.Duplex-guided balloon angioplasty and stent placement appears to be a safe and effective technique for the treatment of femoral-popliteal and infrapopliteal arterial occlusive disease. PAVF <100 mL/min is the most powerful predictor of early (30 days) and midterm (6-month) arterial thrombosis following femoral-popliteal interventions.
authors: Maimonides Medical Center, Division of Vascular Surgery, Brooklyn, New York 11219, USA. eascher@maimonidesmed.org
authors: Enrico
authors: E
authors: Ascher
authors: Anil P
authors: AP
authors: Hingorani
authors: Natalie
authors: N
authors: Marks
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D005260:Female; D005263:Femoral Artery; D006801:Humans; D007866:Leg / Q000098:blood supply*; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery; D015607:Stents; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency