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Intraoperative balloon angioplasty
Insights
Intraoperative balloon dilatation effectively treats lower extremity arterial disease, improving blood flow for claudication and limb salvage. This vascular surgery adjunct shows high patency rates, particularly in aortoiliac procedures.
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.
Abstract:
Since 1981 intraoperative balloon dilatation has been performed in 78 patient suffering from occlusive arterial disease of the lower extremities. The indications were claudication in 32, and limb salvage in 46 patients. In most of the 34 patients in whom a proximal iliac stenosis was dilated in association with a femoro-popliteal bypass (10 patients), endarterectomy (19 patients) or profundoplasty (5 patients), the ankle arm index returned to near normal immediately after the procedure. In 44 patients, the femoro-popliteal segment distal to an ilio-femoral reconstruction was dilated. The follow-up period ranged from 1 to 60 months with an accumulated patency rate of 97.6% in aortoiliac and 60.2% in femoro-popliteal segment at 5 years. Fourteen patients were dead at five years after the intervention from concurrent cardiac disease. Balloon angioplasty is a valuable adjunct to vascular surgery either to improve inflow or outflow in association with surgical reconstruction.