Percutaneous transluminal angioplasty of infrainguinal vessels

In the last decade, percutaneous angioplasty (PTA) has been used with incre asing frequency to treat infrainguinal atherosclerotic lesions. In hopes of better delineating the role of PTA, we undertook a retrospective analysis of infrainguinal PTA in one hospital over a 7-year period. The charts of al l patients receiving infrainguinal PTA from 1989 to 1996 were reviewed. Dem ographics, site and type of lesion, and results of treatment were recorded. Survival curves were plotted using the Kaplan-Meier method following curre nt Society of Vascular Surgery/International Society for Cardiovascular Sur gery (SVS/ISCVS) guidelines. Differences in times to first failure were tes ted using the log rank method. Failures were documented by duplex ultrasoun d. All patients requiring repeat intervention underwent contrast angiograph y. In selected patients with stenotic lesions <3 cm, infrainguinal PTA may be an appropriate initial treatment modality. However, 5-year patency rates are significantly lower than those achieved by saphenous vein grafting. Th e efficacy of the procedure is markedly decreased when used to treat arteri al stenoses >3 cm in length as well as occlusions, and surgical revasculari zation may be a more appropriate initial therapeutic procedure.