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Percutaneous transluminal angioplasty (PTA) of the deep femoral artery
U Hoffmann1, E Schneider, A Bollinger
1Department of Internal Medicine, University Hospital, Zürich, Switzerland.
Insights
Percutaneous transluminal angioplasty (PTA) of the deep femoral artery offers an efficient, less invasive treatment for severe limb ischemia. This procedure demonstrated higher success rates for limb salvage compared to treating claudication.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Cardiovascular Medicine
Background:
- Severe claudication and limb-threatening ischemia often result from superficial femoral artery occlusions.
- Percutaneous transluminal angioplasty (PTA) is a minimally invasive option for treating these arterial obstructions.
Purpose of the Study:
- To evaluate the efficacy and outcomes of percutaneous transluminal angioplasty (PTA) for deep femoral artery occlusions.
- To compare PTA success rates for patients with severe claudication versus those undergoing limb salvage.
Main Methods:
- A retrospective analysis of 43 percutaneous transluminal angioplasties (PTA) performed on the deep femoral artery between 1979 and 1988.
- Patients were categorized into severe claudication (n=15) or limb salvage (n=28) groups.
- Technical success, early clinical success, and long-term outcomes were assessed, with subgroup analysis for additional inflow tract PTA and distal outflow.
Main Results:
- Technical success rate for PTA was high at 95% (41/43 procedures).
- Early clinical success was 60% for claudicants and 68% for limb salvage patients.
- Long-term success rates favored limb salvage patients (48% for claudicants vs. sustained success for limb salvage).
Conclusions:
- Percutaneous transluminal angioplasty (PTA) of the deep femoral artery is an effective, less invasive treatment, especially for limb-threatening ischemia.
- Optimal outcomes are associated with appropriate obstruction morphology and good distal outflow, particularly in limb salvage cases.
Abstract:
Between 1979 and 1988 43 percutaneous transluminal angioplasties (PTA) of the deep femoral artery were performed for treatment of severe claudication (n = 15) or for limb salvage (n = 28). Ateriographically, all patients had a long occlusion of the superficial femoral artery. Additional PTA of significant obstructions in the iliac and common femoral artery were performed in 6 patients of each group. Technical success was achieved in 41 of the 43 procedures (95%). Early clinical success was 60% for claudicants and 68% for patients with limb threatening ischemia. Success rates tended to be higher if additional PTA of the inflow tract was performed (75% versus 61%, n.s.). Patient with a good distal outflow benefited more frequently from PTA if they were treated for limb salvage (p less than 0.05). Within a follow-up period up to 24 months (mean 18.0 months) 5 patients died and one late failure occurred. Life table analysis lasting success in patients dilated for limb salvage, whereas success rate decreased to 48% in claudicants. PTA of the deep femoral artery is a less invasive and efficient treatment particularly for patients with limb threatening ischemia, an appropriate obstruction morphology provided.