Intraoperative balloon angioplasty.

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Peripheral Arterial Disease

Background:

• Occlusive arterial disease of the lower extremities significantly impacts patient mobility and limb viability.
• Surgical reconstruction is a common treatment, but may require adjunct procedures to optimize outcomes.

Purpose of the Study:

• To evaluate the efficacy and outcomes of intraoperative balloon dilatation as an adjunct to vascular surgery for lower extremity occlusive arterial disease.
• To assess the impact of balloon dilatation on ankle-arm index and long-term patency rates.

Main Methods:

• Retrospective analysis of 78 patients undergoing intraoperative balloon dilatation for lower extremity arterial disease since 1981.
• Procedures included dilatation of iliac stenosis in conjunction with femoro-popliteal bypass, endarterectomy, or profundoplasty.
• Dilatation of the femoro-popliteal segment distal to ilio-femoral reconstruction was also performed.

Main Results:

• Immediate improvement in ankle-arm index was observed in most patients with iliac stenosis treated with balloon dilatation and surgical reconstruction.
• Accumulated patency rates at 5 years were 97.6% for aortoiliac segments and 60.2% for femoro-popliteal segments.
• Fourteen patients died within five years, primarily due to concurrent cardiac disease.

Conclusions:

• Intraoperative balloon dilatation is a valuable adjunct in vascular surgery for improving inflow and outflow in patients with lower extremity occlusive arterial disease.
• The procedure demonstrates favorable short-term and long-term patency, particularly in aortoiliac interventions.