Outcome of the First 100 Femoropopliteal Angioplasties Performed in the Operating Theatre

Abstract

Objectivesto examine the factors influencing outcome and restenosis in an initial series of 100 infrainguinal angioplasties.Designprospective study of angioplasties of the superficial femoral and popliteal arteries performed over a 42-month period.Materials and methodsone hundred consecutive angioplasties in 96 patients performed in the operating theatre between January 1993 and June 1996 were followed prospectively with clinical, ABI, and duplex assessment. Forty-four procedures were for disabling claudication and 56 for critical ischaemia. Stents were deployed in 30 limbs.Resultsangioplasty was successful in 84 of 100 limbs. Cumulative patency of the entire group at 3, 6, 12 and 18 months was 78%, 60%, 53%, and 49% respectively, while excluding initial failures, gave patencies of 95%, 69%, 63%, and 58%, respectively. Claudicants with a 1-year patency of 64% did significantly better than patients with critical ischaemia (44%p<0.05). Angioplasties performed during the initial 21 months had a 1-year patency of 42%, while those performed in the final 21 months had a 74% patency (p=N.S.). The patency for stented arteries was 66% vs. 49% for angioplasty alone (p=N.S.). The 2-year limb salvage rate was 91% in patents with critical ischaemia. Forty-six per cent of restenoses were asymptomatic.Conclusionsthe results suggest that while angioplasty is useful in treating infrainguinal arterial disease, there is a learning curve, resulting in a high restenosis rate for occlusive and multilevel disease, while concomitant placement of stents may be beneficial.