Surgical transluminal femoropopliteal angioplasty: multivariate analysis outcome

The purpose of this study was to determine the efficacy of femoropopliteal transluminal angioplasty performed in the operating room by vascular surgeons and the factors that might influence outcome.

The clinical, biologic, and angiographic, findings of 103 consecutive transluminal angioplasties performed in the operating suite in 95 patients for occlusive disease of the femoral or popliteal arteries were analyzed. With each variable, patency was compared according to the log rank test, and a Cox multivariate analysis was applied to the statistically significant variables.

Local, general, and vascular complications occurred in 2.8%, 0.9%, and 2.8% of cases, respectively. The cumulative patency rate was 77.9% +/- 3.9% at 1 month, 59.8% +/- 5.35% at 1 year, and 51.3% +/- 6.15% at 2 years, including early failures (20.7%). Of 11 preoperative factors studied, only the stenotic or occlusive character and the length of the lesion were shown to be statistically significant (p < 0.001 and p < 0.01, respectively). The constructed mathematic Cox proportional hazards regression model allowed definition of the probability of success according to four groups, based on angiographic findings. At 2 years the probability of success was 80% in patients with stenosis less than 2 cm long, 62% in patients with stenosis greater than 2 cm, 42% in patients with occlusion less than 2 cm long, and 20% in patients with occlusion greater than 2 cm long.

Transluminal femoropopliteal angioplasty may be performed safely by vascular surgeons in the operating room. Based on this model, proper selection of patients who might best benefit from transluminal angioplasty for femoropopliteal disease may be made.