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Published on: September 22, 2020
Long-term clinical outcome following lower limb arterial angioplasty
G Morris-Stiff1, M Moawad, N Appleton
1Department of Surgery, Royal Glamorgan Hospital, Ynysmaerdy, Llantrisant, UK.
Insights
Lower limb arterial angioplasty is a safe and effective treatment for peripheral vascular disease, offering high success rates and good patient survival. This study evaluated clinical outcomes in a district general hospital setting.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Cardiovascular Medicine
Background:
- Peripheral vascular disease (PVD) significantly impacts patient mobility and quality of life.
- Lower limb arterial angioplasty is a key intervention for managing PVD.
Purpose of the Study:
- To assess the clinical outcomes of lower limb arterial angioplasty.
- To evaluate safety, efficacy, and long-term results in a district general hospital.
Main Methods:
- Retrospective analysis of 471 angioplasty procedures (1999-2004).
- Data collection included patient demographics, risk factors, indications, complications, limb salvage, survival, and re-stenosis.
- Multivariate analysis identified risk factors for outcome.
Main Results:
- Successful radiological outcome in 88.5% of cases.
- Low complication rate of 9.1%.
- 1, 2, and 3-year patient survival rates were 87.4%, 85.1%, and 83.2% respectively.
- 1, 2, and 3-year cumulative patency rates were 86.0%, 83.1%, and 81.6% respectively.
- Indication for angioplasty and lesion number were risk factors for outcome.
Conclusions:
- Lower limb angioplasty is safe and effective for PVD.
- High technical success and low complication rates were achieved.
- Patient survival and patency reflect the progressive nature of PVD.
Introduction:
The aim of this study was to determine the clinical outcome of lower limb arterial angioplasty in a busy district general hospital practice.
Patients And Methods:
All angioplasties performed from January 1999 to December 2004 were identified and data collected included cardiovascular risk factors, indications for and complications of angioplasty, limb salvage and patient survival rates, and clinically significant re-stenoses.
Results:
471 interventions were performed in 385 patients (231 men, 154 women). The median age was 67.9 years (range: 39-93 years). Indications for angioplasty were critical ischaemia (n=247, 52%) and lifestyle-limiting intermittent claudication (n=224, 48%). Stenotic lesions accounted for 378 (80%) cases and occlusion for 93 (20%). Radiological success was obtained in 417 (88.5%), improving to 93.6% if only those in whom access was achieved were included. Post-angioplasty complications were observed in 42/471 (9.1%) of interventions. The actual patient survival at 1, 2, and 3 years was 87.4%, 85.1% and 83.2% respectively. Indication for angioplasty and the number of lesions present were identified as risk factors for outcome on multivariate analysis. The cumulative post-angioplasty patency rates at 1, 2 and 3 years were 86.0%, 83.1% and 81.6% respectively. The only factor associated with patency was the mode of presentation.
Conclusions:
Angioplasty for lower limb peripheral vascular disease can be performed safely and efficaciously with a high technical success rate and a low complication rate. The patient survival and post-angioplasty patency data reflect the progressive and multi-site nature of the underlying disease process.
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