Percutaneous transluminal dilatation and recanalization in the treatment of peripheral vascular disease.

Abstract

Ninety-four successful transluminal angioplasties were followed up for as long as 15 months, during which time 15 failures occurred. Life-table analysis of this series gave a cumulative patency rate of 64%. The patency rate of 70% for iliac lesions, compared to 50% for the femoral-popliteal group, suggests that the former are likely to have a better long-term prognosis. In selected cases, transluminal angioplasty is a viable alternative to surgery that should be available to both patient and physician.

Treatment of iliac artery stenoses with the Wallstent endoprosthesis.

“…A recurrence rate of 10-30% in iliac angioplasty [3,4] occurs in the first 6 months after the procedure and always has been the major drawback [3,5]. A variety of new approaches to overcome the inadequacies of angioplasty have emerged during the last few years.…”

Percutaneous Transluminal Angioplasty

“…Shunt and fistula failure were manifested by either (1) decreased arterial inflow during hemodial¬ ysis, (2) progressive elevation of pressure in the venous limb of the access, or (3) complete thrombosis of the access. Two patients had Thomas femoral-artery-to-femoralvein shunts, while four had polytef arm fistulas (antebrachial loop or brachial artery to axillary vein).…”

Haemodynamic assessment following iliac artery dilatation

“…Dilatation produces compression and flattening of subintimal atheroma, and in this situation there appeared to be little indication for anticoagulation. We were also concerned to prevent false aneurysm and haematoma formation at the femoral artery puncture site, a common complication in some series (9).…”