The Effectiveness Of Percutaneous Transluminal Angioplasty For The Treatment Of Lower-extremity Arteriosclerosis Obliterans With Low-profile Balloon

Object:To determine the efficacy,safety,and mid-short-term results,including continued primary patency and limb salvage,of percutaneous transluminal angioplasty(PTA) in patients with arteriosclerosis obliterans(ASO) with new introduced low-profile balloon.Methods:From Febuary 2006 to October 2007,49 arteries in 31 patients with ASO were treated by PTA.In some cases,stents were placed selectively for primary PTA failure.Stent placement was limited in infrainguinal lesions.The arteries treated with angioplasty was divided into the above-the-knee group(include iliac artery and the femoropopliteal artery) with 31 arteries(63.27%;atk group),and below-the-knee group(include the three main arteries) with 18 arteries(36.73%;btk group).All analysis was performed according to an intent-to-treat basis.Reporting standards of the Society for Vascular Surgery and the International Society for Cardiovascular Surgery were followed to evaluate initial success,and late follow-up status was evaluated with the Kaplan-Meier method.Patency was evaluated by using ultrasound scanning with waveform surveillance.Results:Perioperative complication rate was 16.13%with no death.Twenty eight limbs gained improvement with different degree.Mean follow-up was 10.68 months (range,3-24 months).Overall,initial technical and clinical success rates were both 90.32%.The cumulative primary patency and limb salvage rates+SE at 24 months were 73.11%±7.58%and 100%respectively.In each subgroup,the primary patency rates±SE at 24 months were 89.47%±5.77%in the atk group;49.47%±14.02% in the btk group.Of all the predictable variables,the arteries treated and TransAtlantic Inter-Society Consensus classification type D were significant independent risk factors for the outcomes(P＜0.05;univariate log-rank test and Cox regression multivariate analysis). Conclusions:PTA is a feasible,safe,and effective procedure for the treatment of ASO.The high limb salvage rate is attributed to the high primary patency rates. Angioplasty can be the primary choice for the treatment of ASO due to lilac and infrainguinal arterial occlusive disease.