Vasodilator response in the lower extremity induced by contrast medium. III. Before and after percutaneous...

A standardized test series of contrast medium injections was performed in the iliac and femoral arteries to evaluate the immediate effect of percutaneous transluminal angioplasty. The vasodilator response recorded by video dilution technique was correlated to radiographic anatomy and symptomatology. Discrepancy between anatomic success and clinical relief of symptoms was found in 26 per cent of the dilatations. The severity of disease at the trifurcation was more marked in combination with femoral lesions than with corresponding iliac lesions. Rest pain was a common symptom with femoral lesions and rare with iliac lesions. Resting blood flow increased significantly after femoral dilatation but was unaffected by iliac dilatations. The video dilution technique provided an accurate staging of the severity of obstructive disease, and was an excellent predictor of subsequent symptomatic success or failure of percutaneous transluminal angioplasty.