Vascular surgical society of great britain and ireland: percutaneous transluminal angioplasty for lower limb ischaemia

Abstract

BACKGROUND: Percutaneous transluminal angioplasty (PTA) is increasingly performed for lower limb ischaemia of all severities, despite the absence of controlled data demonstrating its efficacy. The aim of this study was to examine the indications and outcome for lower limb ischaemia over a 16-year period. METHODS: A prospectively gathered database of 1287 consecutive PTAs performed between 1982 and 1997 was analysed. Two time intervals were compared: 1982-1991 and 1992-1997. RESULTS: Since 1992 there has been a fourfold increase in the number of PTAs performed. There has been a significant increase in the number of PTAs performed for critical ischaemia, occlusive lesions and at infrainguinal sites. Although there has been a significant reduction in morbidity, the number of immediate technical and clinical failures has increased (see Table ). CONCLUSION: Despite a lack of controlled data supporting a more liberal use of PTA in the treatment of lower limb ischaemia, there has been, in this regional vascular unit, a significant increase in the perceived clinical and anatomical indications for the procedure. Randomized controlled trials are urgently required to define the role of PTA in this condition.