INFRARENAL AORTIC-STENOSIS - LONG-TERM CLINICAL AND HEMODYNAMIC-RESULTS OF PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY

PURPOSE: To evaluate the safety and long-term clinical and hemodynamic results of percutaneous transluminal angioplasty (PTA) of the infrare nal aorta. MATERIALS AND METHODS: During nearly 10 years, 102 patients with symptomatic infrarenal atherosclerotic aortic stenosis underwent PTA. Follow-up information was available in 92 patients (17 men, 75 w omen; mean age, 51.9 years). Stenosis involved the aortic bifurcation in 18 patients and only the infrarenal abdominal aorta in 74 patients. Technical success was defined as residual stenosis less than 50% or a pressure gradient less than 10 mm Hg after PTA. Clinical patency was defined as the absence or improvement of symptoms after PTA. Hemodynam ic patency was defined asa normal Doppler waveform in the common femor al arteries,an ankle-brachial ratio greater than 0.95, or the absence of a thigh-brachial pressure gradient. RESULTS: Technical success was achieved in 78 patients after PTA. After 10 years, primary clinical an d hemodynamic patency rates were 72% and 46%, respectively. After a me an follow-up of 51 months, 15 of the 22 symptomatic recurrences were d ue to aortic restenosis; 11 of these were treated with repeated PTA wi th or without stent placement, and three eventually required aortic su rgery. No morbidity was encountered. CONCLUSION: Infrarenal aortic PTA proved to be safe and provided durable, long-term clinical improvemen t. In this group of relatively young patients, the clinical patency ra te of PTA was equivalent to that of aortic surgery but with less morbi dity.