Transluminale Angioplastie — Stellenwert in der femoropolitealen Revaskularisation: Langzeitergebnisse

Summary

Patients with multilevel arterial occlusive disease represent a challenging problem. A retrospective review of 87 consecutive patients (pts) treated with a femoropopliteal reconstruction combined either with iliac (46 pts, 48 procedures, group 1) or infrapopliteal angioplasty (48 pts, 52 procedures, group 2) was performed. Average age was 64.7 years and follow-up ranged from 1 to 6 years (mean 24.1 months). Indication was severe claudication in 43% and 20%, rest pain in 21% and 32%, tissue necrosis in 36% and 48% of the respective groups. In group 1, two postoperative deaths occurred and three serious complications (7.3%). Primary failure rate was 19%. In group 2, six patients had serious angioplasty-related complications (13%) and one peroperative death occurred. Eleven procedures were judged failures (24%). Secondary procedures were effective in nine patients. Mean antebrachial index improved from an average of 0.35 to 0.78. Life-table analysis revealed a secondary patency rate in group 1 of 86% at 1 year, 80% at 2 years, and 65% at 5 years, and in group 2:73%, 63%, and 37%, respectively. Eleven patients underwent amputation. The authors conclude that femoropopliteal reconstruction combined with distal angioplasty is effective for multilevel occlusive disease. Intraoperative digital subtraction angiography and no-profile coaxial balloon catheters may significantly improve immediate results.