5-year Results of a Prospective Study of Percutaneous Transluminal Angioplasty

Abstract

This paper presents the results of a prospective study of percutaneous transluminal angioplasty (PTA) for the treatment of patients with peripheral arterial occlusive disease and identifies the variables that are predictive of long-term success. The variables believed to be important prognostically were recorded for 984 consecutive PTAs performed between July 1978 and July 1986. Success or failure was defined using a combination of clinical and objective vascular laboratory criteria. The overall long-term success was estimated by the Kaplan-Meier method and differences between curves of success rate versus time for each variable were determined by the Wilcoxon and log-rank statistics. The combination of variables associated with success were determined by the Cox proportional hazards regression model. For all cases, the initial success rate was 88.6 +/- 1.0% and at 5 years was 48.2 +/- 2.3%. The following variables, when considered individually, were associated with success (p less than 0.05): indication for PTA, site of PTA, severity of lesion, runoff, number of sites dilated, diabetes, and the occurrence of a complication. From the Cox model, by using a stepwise multiple regression procedure, the following combination of variables were found to be predictive of success (p less than 0.05): (1) indication (claudication vs. salvage), (2) site (common iliac vs. other), (3) severity of lesion (stenosis vs. occlusion), and (4) runoff (good vs. poor). For all combinations of these four significant variables, curves of the success rate versus time were calculated. In conclusion, this study has identified the combination of four variables that together predict if PTA is likely to be successful in the management of a patient with peripheral arterial occlusive disease.

Long-Term Results of Combined Aortoiliac and Infrainguinal Arterial Reconstruction for the Treatment of Critical Limb Ischemia

“…14) Previous reports illustrated that poor runoff is an independent predictor of adverse outcome after iliac endovascular interventions. 15) Infl ow lesions will also have a determined effect on the long-term patency of infrainguinal surgical reconstruction. Therefore, the combined procedure would have a benefi cial result concerning the patency of both iliac and infrainguinal lesions.…”

Hybrid Endarterectomy and Endovascular Therapy in Multilevel Lower Extremity Arterial Disease Involving the Femoral Artery Bifurcation

“…[23][24][25][26] However, endovascular surgery has less favorable outcomes for some lower extremity arteries, such as the common femoral and deep femoral arteries. [27][28][29][30] On the other hand, open endarterectomy of the common femoral artery is simple, has low morbidity and high patency rate, and can be combined with any other endovascular technique. In the 1960-1980s, many reports were proving that endarterectomy at the level of the FB is an efficient procedure with a durable outcome.…”

Clinical Outcome of Surgical Endarterectomy for Common Femoral Artery Occlusive Disease

“…Patients who had undergone previous CFE or previous or concurrent bypass grafts utilizing the CFA for either proximal or distal solated occlusive disease of the common femoral artery (CFA) is uncommon and tends to often be associated with aorto-iliac or femoro-popliteal atherosclerosis. 1 The plaques in the region are often bulky, eccentric and highly calcified, and can be complex due to the involvement of the femoral bifurcation. Moreover, the CFA is important as an access site to various endovascular procedures and a strategic region that carries the aorto-iliac artery, femoro-popliteal artery and their collaterals.…”