Impact of percutaneous transluminal angioplasty

✍ Scribed by E. Amsterdam; Z. Rubinstein; R. Adar

• Publisher: John Wiley and Sons
• Year: 1986
• Tongue: English
• Weight: 57 KB
• Volume: 73
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.1800731145

✦ Synopsis

Impact of percutaneous transluminal angioplasty

Sir

The impact of new techniques of the management of surgical problems is subject to regional variations. In their interesting article (Br J Surg 1986; 7 3 17-19) Anderson et al. reached the conclusion that the introduction of percutaneous transluminal angioplasty (PTA) in a Plymouth hospital did not replace vascular reconstructive surgery (VRS). They advocate allocation of extra resources to enable an increase in level of care afforded by this technique. In the USA Doubillet and Abrams becried underutilization of PTA' alluding that vascular surgeons are reluctant to refer patients who are also attractive candidates for VRS.

In our setting of medical care delivery PTA has become first choice in all patients judged amenable to it. Unlike the policy of Anderson et al. we have not relaxed our indication for arteriography, which is still performed only for crippling claudication or limb salvage. Analysing our results in 71 limbs of 65 patients who underwent femoropopliteal PTA we found 73 per cent successful outcomes, 14 amputations and one death. A simulated algorithm for these same limbs, assuming unavailability of PTA (or non-referral), resulted in a similar success to failure ratio.