Outcome of subintimal angioplasty in a district general hospital

Abstract

Abstract Background The results from major institutions of subintimal angioplasty are good. The aim was to determine the early and intermediate outcome of the technique of subintimal angioplasty in a district general hospital. Methods After formal training, two consultant radiologists performed subintimal angioplasty on 50 consecutive patients for the treatment of intermittent claudication (23 patients) and ulceration or gangrene (27). Patients were classified as Rutherford grade III–VI. The patient group contained 35 men and 15 women with a median age of 72 (range 45–93) years. The median treated length was 17·5 cm in the superficial femoral artery, 12·5 cm in the popliteal artery and 7·5 cm in the peroneal artery. Those with a technically successful procedure were followed with clinical assessment at 6 weeks and colour duplex ultrasonography at 6 months. Results Thirty-nine (78 per cent) of the 50 procedures were technically successful. Sixty per cent of these were patent at 6 months on colour duplex ultrasonography. The primary technical success rate in the first 25 consecutive patients to undergo angioplasty was 64 per cent (16 patients), compared with 92 per cent (23 patients) in the second group of 25; this difference was significant (P = 0·004, χ2 test). The overall patency rate at 6 months in the first 25 consecutive patients was 43 per cent, compared with 69 per cent in the second 25; this difference was statistically significant (P = 0·02, χ2 test). Conclusion After a short learning interval, subintimal angioplasty can be used effectively in a district general hospital, with good medium-term patency rates.