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Are infra-inguinal angioplasty and surgery comparable?
1Regional Vascular Unit, St Mary's Hospital, London, UK.
Acta Chirurgica Belgica
|April 17, 2001
Summary
Percutaneous Transluminal Angioplasty (PTA) for infrainguinal peripheral arterial occlusive disease lacks high-level evidence for consensus. Surgical bypass is often necessary for limb salvage in critical limb ischemia.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Peripheral Arterial Disease
Background:
- Indications for Percutaneous Transluminal Angioplasty (PTA) in infrainguinal peripheral arterial occlusive disease remain controversial.
- Comparing conservative management, PTA, and surgical approaches requires up-to-date data.
Purpose of the Study:
- To provide current data comparing conservative management and surgical approaches for infrainguinal peripheral arterial occlusive disease.
- To assess the role of PTA in treating femoropopliteal occlusive disease.
Main Methods:
- A comprehensive literature review was conducted using Medline and Ovid.
- The review focused on recent reviews, meta-analyses, and high-evidence studies.
- Cross-referencing of selected literature was performed.
Main Results:
- PTA suitability for femoropopliteal disease depends on presentation severity and disease extent.
- Optimal lesions for PTA represent a small patient percentage.
- PTA offers lower mortality and shorter stays but has a higher secondary procedure rate.
- Critical limb ischemia often necessitates surgical procedures for limb salvage.
Conclusions:
- High-level evidence for a consensus on PTA's role in femoropopliteal occlusive disease is lacking.
- PTA is suitable for only a small subset of patients.
- Surgical bypass is frequently required for limb salvage, making direct technique comparison difficult.