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Does peripheral angioplasty compromise limb blood flow?
P J Thorley1, K L Sheard, M R Rees
1Radionuclide Department, Killingbeck Hospital, Leeds, UK.
Insights
Peripheral angioplasty outcomes were assessed using isotope limb blood flow studies. A significant number of untreated limbs also showed reduced blood flow, suggesting systemic factors may affect outcomes.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Radiology
Background:
- Peripheral angioplasty aims to improve limb blood flow.
- Assessing angioplasty success requires evaluating blood flow changes.
Purpose of the Study:
- To evaluate the outcome of peripheral angioplasty using isotope limb blood flow studies.
- To compare different angioplasty techniques (balloon, laser, Kensey).
Main Methods:
- Isotope limb blood flow and Doppler ankle-brachial pressure measurements were taken before and 6 months after angioplasty.
- 101 angioplastied limbs and 53 contralateral untreated limbs were studied.
Main Results:
- 17% of angioplastied limbs showed a decrease in blood flow at 6 months, with no significant difference between techniques.
- 25% of untreated limbs also showed reduced blood flow.
- Reduced blood flow in untreated limbs was more common when the treated limb did not improve.
Conclusions:
- A fall in limb blood flow post-angioplasty may not solely indicate angioplasty failure.
- Systemic factors might adversely affect blood flow in both treated and untreated limbs in some patients.
Abstract:
Isotope limb blood flow studies were carried out using balloon, laser and Kensey catheter techniques to assess the outcome of peripheral angioplasty. Limb blood flow and Doppler ankle-brachial pressure measurements were obtained before angioplasty and at 6 months after angioplasty in a total of 101 angioplastied limbs: A fall in limb blood flow at 6 months was seen in 17% of the angioplastied limbs with no significant difference in the figures for the different types of angioplasty. Limb blood flow was also measured in 53 contralateral untreated limbs, approximately half of the patient group having both legs angioplastied. 25% of untreated limbs showed a fall in limb blood flow. Significantly more of the untreated limbs showed a fall in limb blood flow at 6 months where the contralateral, treated limb did not improve as a result of the angioplasty compared with those patients where the angioplastied leg improved. These results suggest that a lack of improvement in blood flow in the angioplastied limb may not result from failure of the angioplasty but may be the result of some factor, or combination of factors, which adversely affects both the angioplastied and the untreated leg in some patients.