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Percutaneous transluminal angioplasty for severe lower extremity ischaemia
Insights
Percutaneous transluminal angioplasty (PTA) offers a cost-effective solution for advanced peripheral vascular disease. This study shows a high technical success rate and significant limb salvage, making PTA a valuable treatment option.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Peripheral Artery Disease
Background:
- Advanced peripheral vascular disease presents significant limb-threatening ischemia.
- Percutaneous transluminal angioplasty (PTA) is an alternative to surgical revascularization.
Purpose of the Study:
- To evaluate the efficacy and safety of PTA in patients with advanced ischemia.
- To identify factors influencing PTA outcomes in peripheral vascular disease.
Main Methods:
- Seventy PTA procedures were performed in 63 consecutive patients with advanced ischemia.
- Life-table analysis was used to assess long-term success rates.
- Complications and associated factors were analyzed.
Main Results:
- Technical success rate was 91% (64/70 procedures).
- Clinical improvement was maintained at 6 months in 73% (51/70).
- Overall limb salvage was 76%, with a 9% complication rate.
Conclusions:
- PTA is a technically successful and cost-effective procedure for advanced peripheral vascular disease.
- Cardiac disease, younger age, and greater disease extent are associated with poorer outcomes.
- PTA offers a valuable treatment option with significant limb salvage rates.
Abstract:
Percutaneous transluminal angioplasty (PTA) was attempted on 70 occasions in 63 consecutive patients presenting with advanced ischaemia. The procedure was technically successful in 64 (91%) with haemodynamic improvement in 39 (56%) and clinical improvement maintained at 6 months in 51 (73%). Follow-up ranged from 6 months to 4 years and life-table analysis showed 60% success at 1 year and 58% success at 2 years. Overall limb salvage was 76%. Complications occurred in 6 (9%) and in one case this lead to amputation. The relationship of a number of associated factors to outcome was assessed. The presence of cardiac disease requiring treatment for failure or angina was a highly significant adverse factor (P less than 0.001). Decreasing age and greater extent of disease were also significant adverse factors (P less than 0.05). Therefore, because of its low morbidity and cost, PTA can be seen as a useful procedure in patients presenting with advanced peripheral vascular disease.