Outcome in patients with failed percutaneous transluminal angioplasty for peripheral vascular disease

The outcome in 299 patients having 321 percutaneous transluminal angioplasty (PTA) procedures for peripheral vascular disease was analysed. Technical failure occurred in 21 patients (7%) but in none was the limb ischemia made worse by the failed PTA attempt; nine of these (3%) had been considered unsuitable for arterial reconstruction and proceeded to primary amputation, while 12 (4%) did not have subsequent management compromised by the failed PTA attempt. Complications occurred in seven patients (2.3%); four of these (1.3%) had worsening ischemia but were able to be satisfactorily managed by surgical intervention. There were 71 patients (23.7%) who had an initially successful PTA procedure which subsequently failed; 20 of these (6.7%) had been considered unsuitable for arterial reconstruction and proceeded to amputation, while five patients suitable for arterial reconstruction (1.7%) came to amputation, four following failed bypass surgery and one following multiple trauma from a motor vehicle accident. The remaining 46 patients (15.3%) did not have subsequent management compromised by the late failure of PTA. Early and late failure of PTA in patients presenting with peripheral vascular disease does not compromise subsequent management.