Interventional angiology

Percutaneous transluminal angioplasty in peripheral artery occlusive disease by balloon catheters is the standard method in interventional angiology. For almost twenty years it has been recommended in the aorto-iliac region for arterial stenoses, and in the femoro-popliteal arteries for stenoses and short occlusions. Due to progress in technology of catheters and guide wires, a primary success rate of more than 90% is to be expected with favourable angiographic conditions. The long-term patency rate of some 90% on the aorto-iliac level exceeds that of 70-90% on the femoro-popliteal level. The patency rate decreases with increasing complexity of the lesions. Subacute/acute occlusions of the femoro-popliteal arteries by thrombosis or embolism are treated successfully in 80% of cases by catheter-thrombolysis and/or thrombus aspiration combined with percutaneous transluminal angioplasty if necessary. Several new techniques are under clinical evaluation, such as laser angioplasty, rotational catheters, atherectomy catheters and stents. Their application in clinical routine has up to now not been justified except for special situations such as obtaining biopsy material by Simpson catheter or maintenance of patency in balloon resistant lesions by stents.