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Balloon angioplasty by vascular surgeons
F A Madera1, P M Orecchia, R A Razzino
1Department of Surgery, Pinnacle Health Hospitals, Harrisburg, Pennsylvania 17110, USA.
American Journal of Surgery
|August 1, 1997
Summary
Vascular surgeons effectively perform balloon angioplasty for extensive lower extremity arterial disease, achieving high success rates with low complications. This endovascular treatment is crucial for limb salvage in complex cases.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Cardiology
Background:
- Endovascular treatment for lower extremity arterial disease is a multidisciplinary approach.
- Vascular surgeons are increasingly involved in endovascular interventions.
- This study focuses on the outcomes of endovascular procedures performed by vascular surgeons.
Purpose of the Study:
- To evaluate the complication and success rates of endovascular treatment for extensive lower extremity occlusive disease.
- To assess the effectiveness of balloon angioplasty when performed by vascular surgeons.
Main Methods:
- Retrospective review of 239 lower extremity revascularization procedures (336 vascular segments) in 200 patients (April 1990 - May 1996).
- Procedures included balloon angioplasty, angioplasty with bypass, and combined angioplasty/surgery.
- Success was assessed by immediate and late technical outcomes (angiography, pressure gradients, ABI, duplex imaging) and late clinical success (symptom relief).
Main Results:
- Indications included claudication (51%), limb threat (45%), and failing grafts (4%).
- Complications occurred in 3% of cases (9/239), with a 30-day mortality of 0.5% (2/200).
- Immediate technical success ranged from 84% (tibial) to 93% (aortoiliac); late technical success ranged from 67% (femoral) to 81% (aortoiliac).
Conclusions:
- Balloon angioplasty is an effective endovascular treatment option for vascular surgeons to manage extensive lower extremity arterial disease.
- The procedure demonstrates a low complication rate, supporting its use in limb salvage scenarios.
- Effective treatment of multilevel disease is achievable with these endovascular techniques.