Related Experiment Videos
Percutaneous transluminal angioplasty for the ischaemic lower limb: the early Dunedin experience
D T Reilly1, S G Packer, N Morrison
1Department of Surgery, University of Otago Medical School, Dunedin.
Insights
Percutaneous transluminal angioplasty (PTA) effectively treats severe peripheral artery disease. This study shows high success rates for PTA in managing claudication and critical limb ischemia, avoiding further procedures.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Cardiovascular Medicine
Background:
- Severe peripheral artery disease (PAD) significantly impacts patient quality of life.
- Interventional radiology offers minimally invasive treatment options for PAD.
Purpose of the Study:
- To evaluate the efficacy and long-term outcomes of percutaneous transluminal angioplasty (PTA) in patients with severe peripheral ischemia.
- To assess PTA success rates based on lesion location (iliac vs. femoropopliteal) and presenting symptoms (claudication vs. rest pain/necrosis).
Main Methods:
- A series of 60 percutaneous transluminal angioplasties were performed on 53 patients with severe peripheral ischemia over 4 years.
- Seventy-eight lesions were dilated, with an initial technical success rate of 78%.
- Follow-up averaged 24 months for initially successful angioplasties.
Main Results:
- For claudication, 59% of iliac lesions and 86% of femoropopliteal lesions remained improved at 2 years.
- For rest pain or necrosis, 100% of iliac lesions and 49% of femoropopliteal lesions showed success at 2 years.
- At 2 years, 85% of claudicants and 72% of patients with rest pain/necrosis avoided further procedures.
Conclusions:
- Percutaneous transluminal angioplasty is a successful treatment for severe peripheral ischemia in high-risk patients.
- PTA demonstrates durable results, particularly for iliac lesions, in managing symptoms and preventing repeat interventions.
- Interventional radiology plays a crucial role in the management of peripheral vascular disease.
Abstract:
A consecutive series of 60 percutaneous transluminal angioplasties has been performed in 53 patients with severe peripheral ischaemia over a 4 year period. There were 78 lesions dilated with an initial technical success rate of 78%. Forty-eight lesions were dilated for severe claudication and 30 for rest pain or necrosis. There was a mean followup of 24 months (range 9-56) for the immediately successful angioplasties. When these were analysed according to symptomatic relief, 59% of claudicants with iliac lesions were still improved at 2 years, compared with 86% of those with femoropopliteal lesions. Amongst patients treated for rest pain or necrosis there was a 100% success rate at 2 years for iliac lesions, compared with 49% for femoropopliteal lesions. The overall success of this procedure in this high risk group is reflected by the fact that at 2 years 85% of claudicants and 72% of those with rest pain and necrosis have avoided any further procedure. This encouraging early experience confirms the place of interventional radiology in the management of peripheral vascular disease.