Percutaneous transluminal angioplasty without anticoagulation.

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Radiology

Background:

• Peripheral artery disease (PAD) affects numerous patients, causing claudication and severe ischemia.
• Percutaneous transluminal angioplasty (PTA) is a common revascularization technique for PAD.
• The role of anticoagulation/antiplatelet therapy during PTA is debated.

Purpose of the Study:

• To evaluate the safety and efficacy of PTA without anticoagulation or antiplatelet drugs.
• To determine success rates of PTA in different leg arteries (iliac, femoral, popliteal).
• To analyze complications associated with PTA in this patient cohort.

Main Methods:

• Retrospective study of 110 consecutive patients undergoing PTA.
• No anticoagulation or antiplatelet drugs used during or after the procedure.
• Success defined by clinical improvement, Doppler studies, and radiographic appearance; analyzed using life-table analysis.

Main Results:

• High success rates observed: iliac (90% at 1 month, 85% at 3 months), femoral (83% at 1 month, 79% at 3 months), popliteal (71% at 1 month, 57% at 3 months).
• Majority of stenoses were 50%-75% (61%), with 18% complete occlusions.
• Low complication rate (9.1%) including death, thrombosis, perforation, hematoma, and false aneurysm; no amputations required.

Conclusions:

• PTA can be performed safely and effectively without anticoagulation, minimizing associated risks.
• PTA demonstrates favorable outcomes, particularly in the iliac arteries.
• This approach offers a viable treatment option for patients with PAD, avoiding unnecessary medication risks.