Outcome of femoropopliteal angioplasty

Objective To assess prospectively the outcome of femoropopliteal angioplast y and investigate prognostic indicators of success. Background Percutaneous transluminal angioplasty is commonly used to treat symptomatic femoropopliteal stenoses or occlusions, but the durability of t he procedure is uncertain. Methods Seventy-four consecutive patients treated by femoropopliteal angiop lasty for intermittent claudication (43), rest pain (4), and tissue loss (2 7) were followed by assessment of symptoms, ankle-brachial pressure index ( ABPI) to measure hemodynamic outcome, and duplex monitoring of velocity gra dient at the angioplasty site to identify restenosis at 1 day and 3, 6, 9, and 12 months. Univariate comparisons, life table analysis, and backward st epwise regression were used to investigate factors predicting the symptomat ic and hemodynamic outcome and restenosis. Results Technical success was obtained in 67 patients (91%); failure occurr ed in 7 patients. At 1 year, a successful symptomatic outcome was achieved in 35 patients (51%), hemodynamic success was achieved in 41 patients(58%), and restenosis developed in 39%. ABPI at 24 hours after angioplasty was th e most significant variable predicting a symptomatic outcome, hemodynamic o utcome, and restenosis at 12 months. Life table analysis demonstrated that in 24% of patients with a 24-hour ABPI greater than or equal to 0.9, resten osis developed by 12 months, compared with 64% of patients with a 24-hour A BPI <0.9. Conclusion Only half of the patients treated by femoropopliteal angioplasty had symptomatic improvement at 1 year, raising concern about the cost-bene fit ratio of this procedure. Restoration of ABPI to >0.9 predicted a favora ble outcome.