Percutaneous transluminal angioplasty: review of iliac and femoral dilatations at the Cleveland Clinic1

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Thirty-five iliac and 25 femoropopliteal percutaneous transluminal angioplasties (PTA) were performed at the Cleveland Clinic between February 1979 and April 1983. Patients were considered for PTA if they had disabling claudication, ischemic rest pain, ischemic ulceration or gangrene, or an arterial stenosis or occlusion that met the necessary radiographic criteria. Overall, 87% of the PTAs were an early success, and 63% remained successful at an average follow-up of eight months. The success rate for iliac PTA was 89%, with a late success rate of 74% if both the femoral and profunda femoris arteries were patent. These success rates decreased to 50% early and 25% late if only one femoral artery was patent. The femoropopliteal PTA group had an incidence of 80% early success and 56% late success. If three tibial outflow vessels were patent, the late success rate was 75%. When one or two of the tibial vessels were patent, the late success rates were 45% and 63%, respectively. The follow-up period in both groups was 9 to 11 months. The success rate for PTA is generally lower than that for surgical revascularization in patients with similar clinical symptoms and arterial pathology. However, PTA poses several advantages over surgical revascularization and should be considered, especially in the poor-risk patient.



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