Cardiac complications in vascular procedures: comparison of percutaneous angioplasty and surgery

Percutaneous transluminal angioplasty (PTA) is currently recommended to high risk cardiac patients as a relatively safer procedure compared to reconstructive peripheral vascular surgery (RPVS). In order to evaluate this approach we studied the incidence of cardiac complications in 86 consecutive patients undergoing peripheral vascular procedures. 45 patients (Group I) underwent RPVS and 41 (Group II) PTA. The two groups were comparable regarding age, sex, the location of vascular lesions, the incidence of previous MI (Group I--40%, Group II--46%), and the incidence of angina pectoris (I--25%, II-29%). No special treatment or monitoring was used for patients with ischemic heart disease (IHD) in the PTA group. Successful revascularization was achieved in 36 (80%) of the surgical patients and 25 (61%) of the patients who underwent PTA. There were two anginal attacks, two MIs, and one cardiac death in group I compared to six anginas, three MIs, and one death in Group II. These differences are not statistically significant. It is concluded that PTA carries a definite risk of cardiac complications in patients with known IHD.