Below-the-knee angioplasty: Tibioperoneal vessels, the acute outcome

✍ Scribed by Dorros, Gerald ;Lewin, Ruben F. ;Jamnadas, Pradip ;Mathiak, Lynne M.

• Book ID: 102791143
• Publisher: John Wiley and Sons
• Year: 1990
• Tongue: English
• Weight: 996 KB
• Volume: 19
• Category: Article
• ISSN: 0098-6569
• DOI: 10.1002/ccd.1810190305

✦ Synopsis

Conventional balloon angioplasty (PTA) was attempted in 111 patients (60% male; mean age 6729 years) with 168 below-the-knee, tibioperoneal vessels (TPV) lesions. The presenting predominant symptoms were claudication in 52 (47%), non-healing ulcer/gangrene in 30 (27%), and rest pain in 29 (26%) of patients. An abovethe-knee vessel was dilated before TPV angioplasty in 62 patients (56%). A successful PTA was achieved in 152/168 (9O%)TPV: stenoses, 124/125 (99%); occlusions, 28/43 (65%). Complications encountered included contrast-induced renal failure (4%), distal embolization (4%), entry site arterial repair or embolectomy (2%), dissection or occlusion (2%), and groin hematoma (2%). A significant complication (death, emergency bypass surgery, or distal embolization) occurred in only 3 patients (So/,); no complications whatsoever were found in 100 patients (90%). At discharge, 106 patients (95%) were clinically improved. A restenosis andlor second PTA procedure occurred in 44/108 patients (40%) (mean time: 9+6 months) with the presenting predominant symptom being claudication in 38 patients (86%). However, only 36% of patients had lesion recurrence with or without new disease, and 64% showed evidence of disease progression with symptoms. Angiographic and clinical success was achieved in 42 patients undergoing second PTA (96°/0). These data indicate that balloon angioplasty can be successfully utilized in patients with symptomatic obliterative disease of the tibioperoneal vessels with excellent success, a low risk of complications, and good clinical improvement, PTA of the below-knee vessels should not be restricted to patients in limb salvage situations.