[Transluminal angioplasty in a surgical setting. 150 cases]

Since 1985, 150 transluminal angioplasty operations have been performed by surgical teams, in the operating theater, for treatment of atheromatous lesions of the lower extremities, either as a complement to or in replacement of direct surgical repair. 150 angioplasties were carried out on patients with severe stage II lesions (72%). There was one or several significant stenosis in 140 of cases, and one short segmental thrombosis in 10 cases (1 common iliac and 9 superficial femoral or popliteal). These angioplasties fell into the following categories: 60 iliac, 78 femoral-popliteal and 12 angioplastic repairs of stenosis to iliac or distal femoral surgery (anastomosis, grafting, endarterectomy...). Angioplasty was combined with revascularization or lumbar sympathectomy in 29% of cases. It was performed singly in most cases (71%) and carried out percutaneously (45%) or by limited superficial proximal femoral approach under local anesthesia (26%), either directly or when the percutaneous approach failed. Eight cases of thrombosis (5.3%) developed during the first month: 2 cases after iliac angioplasty and 6 cases after femoral-popliteal angioplasty. Five deaths occurred consecutively to myocardial infarction. At long term, 4 cases of iliac thrombosis and 3 cases of thrombosis complicating femoral-popliteal angioplasty were detected. The overall cumulative permeability rate was 89% at 30 months, and there was no significant difference at one year's time between iliac and femoral-popliteal angioplasty patients (90% and 86%, respectively). Data collected from digital angiographic monitoring allowed to detect 9 cases of residual or recurrent stenosis (2 iliac, 6 femoral-popliteal and 1 postoperative lesions). Two repeat femoral-popliteal angioplasties were successfully performed.(ABSTRACT TRUNCATED AT 250 WORDS)