Intermediate Results of Infrainguinal Percutaneous Transluminal Angioplasty

ABSTRACT

PURPOSE: Percutaneous transluminal angioplasty (PTA) is being increasingly used as a primary treatment for critical limb ischemia (CLI). The aim of this study was to evaluate the results of performing PTA for the superficial femoral arteries (SFA) for treating CLI or claudication. METHOD: From April 2003 to February 2007, PTA of the SFA was performed on 44 limbs in 39 patients. The mean follow-up was 10.1 months. RESULT: The demographic features included a mean age of 67.6 years; the patients were 89.7% males, and CLI was present in 56.8% of the subjects. The lesions were classified according to the TransAtlantic Inter-Society Consensus (TASC) as A (6.8%), B (40.9%), C (31.8%) and D (20.5%). PTA was confined to the SFA in 29 limbs (65.9%), and 15 patients (34.1%) underwent concurrent interventions in other anatomic locations. The SFA interventions included angioplasty only in 9 limbs (20.5%) and at least one stent in 35 limbs (79.5%). Clinical success was obtained in 33 limbs (75.0%) and limb salvage for CLI was achieved in 80% limbs (20/25 limbs). The complications included two access site hematomas and six intimal dissections. Interval conversion to bypass surgery was done in 5 limbs and major amputation was performed in 4 limbs. One patient died perioperatively after bypass surgery. The primary patency rates were 83.0% at 3 months, 78.9% at 6months and 72.3% at 12 months. The variables associated with the inferior primary patency rate by univariate analysis included CLI, the type of lesions (TASC A/B vs C/D), and the length of the treated lesions (P=0.01, P=0.008 and P=0.007, respectively). The modified runoff scoring system was predictive of PTA failure (P=0.003). CONCLUSION: PTA of the SFA for treating CLI or claudication is feasible and safe, and it provides acceptable clinical results. It would be appropriate to use PTA as the initial treatment option for chronic superficial femoral occlusive disease.