[Different methods of percutaneous desobstruction of peripheral arteries]

Chronic arterial occlusion of the iliac and femoro-popliteal vessels has been considered, until recently, to be a contraindication to percutaneous transluminal angioplasty. However, recent advances in radiological and catheterisation equipment and the introduction of new methods of recanalisation (laser, mechanical devices) have increased the therapeutic possibilities. The immediate and long-term results of iliac recanalisation are usually excellent with conventional angioplasty methods. The success rate of recanalisation of the femoro-popliteal segments is about 80% irrespective of the method used, the failure rate increasing with the length of the occlusion. However, the long-term patency rate is poor, about 50%. These methods of percutaneous recanalisation are technically difficult and require special training and sophisticated equipment. The indications should be carefully evaluated in a pluridisciplinary manner taking into account the potential clinical benefits, the technical difficulties, the risks and other therapeutic possibilities.