Document Detail


Total occlusion of iliac arteries: results of balloon angioplasty.
MedLine Citation:
PMID:  8334688     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Fifty-six occluded iliac arteries (mean length 6.1 cm; range 1-17 cm) in 50 patients were treated by percutaneous transluminal angioplasty (PTA) or laser-assisted PTA (bilateral lesions in 6 patients). Twenty-seven patients (54%) were at high risk for surgery. Patients were followed for a maximum period of 72 months (mean 23.12 months; median 20 months). The initial success rate was 78.57% for arteries and 82% for patients. Laser-assisted PTA was attempted in 11 occluded arteries (19.64%) and was successful in 4 arteries (7.14%). Conventional PTA was successful in 71.4% of arteries including all 7 arteries for which laser-assisted PTA failed (76% of patients). PTA was unsuccessful in 12 arteries (21.43%). Urokinase was used before PTA in 1 artery. The effect of PTA was evident clinically by relief of rest pain (66.66%), healing of ulcer (57%), increased claudication distance or no claudication (79%) in limbs, and objectively, by improvement in ankle/arm index (AAI) (an increase of 0.16 to 0.91) and increased exercise tolerance. Continuous improvement in AAI was observed after PTA on follow-up in 9 limbs. One patient died during follow-up. On follow-up, 3 arteries were occluded, 6 showed evidence of stenosis, and 1 showed fusiform dilatation at the PTA site. The long-term results using the life-table method determined a 76% primary patency rate and 81% secondary patency rate for 72 months. The overall patency including failures was 63%. Age of the patients (p = 0.0169) and hypertension (p = 0.0015) significantly affected the long-term patency of the artery but not the initial success. The major complications were arterial rupture in a repeat procedure in 1 artery, axillary artery thrombosis in 1, and distal thromboembolic occlusion during PTA in 4. The long-term patency rates suggest that PTA of totally occluded iliac arteries is a safe and effective procedure and provides a long-term benefit.
Authors:
A K Gupta; K Ravimandalam; V R Rao; S Joseph; M Unni; A S Rao; K S Neelkandhan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cardiovascular and interventional radiology     Volume:  16     ISSN:  0174-1551     ISO Abbreviation:  Cardiovasc Intervent Radiol     Publication Date:    1993 May-Jun
Date Detail:
Created Date:  1993-08-26     Completed Date:  1993-08-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8003538     Medline TA:  Cardiovasc Intervent Radiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  165-77     Citation Subset:  IM    
Affiliation:
Department of Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angioplasty, Balloon* / adverse effects
Arterial Occlusive Diseases / radiography,  therapy*
Female
Humans
Iliac Artery* / radiography
Life Tables
Male
Middle Aged
Recurrence
Vascular Patency

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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