Angiographic characteristics of symptomatic recurrent disease after infrainguinal percutaneous transluminal angioplasty

Purpose: To evaluate the angiographic patterns of clinically manifest recur rent disease after infrainguinal percutaneous transluminal angioplasty (PTA ) of stenoses and total occlusions. Methods: Among 326 infrainguinal PTAs on 263 consecutive patients, selectiv e angiography was performed on 61 limbs of 52 patients 1-60 months after th e primary intervention because of clinically suspected recurrent disease. L esion-specific and patient-related factors were analyzed for 75 angiographi cally confirmed recurrent lesions in 57 limbs of 48 patients. Results: Recurrent disease was more frequently a stenosis when the original target lesion was a stenosis (92%, 44/48) than when the original lesion wa s a total occlusion (59%, 16/27; p < 0.001). When the original target lesio n was a stenosis, the total length of the recurrent disease was longer than that of the original lesion [3.9 +/- 3.9 cm (mean +/- standard deviation) vs 2.8 +/- 2.7 cm; p = 0.03], while in the subgroup of original total occlu sions the length of the recurrent lesion was shorter than that of the origi nal occlusion (7.1 +/- 5.0 cm vs 9.9 +/- 6.9 cm; p = 0.02). Half the resten oses (22/44) extended beyond one or both ends of the original stenosis and 38% (6/16) of the reocclusions ex tended beyond the distal end of the origi nal occlusion. Conclusions: The type of recurrent disease depends on the original lesion t ype and the restenotic lesion frequently extends beyond one or both ends of the original target lesion.