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The article by Dotter and co-workers "Transluminal Iliac Artery Dilatation," (p 117) will be read by a wide circle of physicians and the technique described will appear to be a welcome substitute for aortoiliac surgery. I believe that the case for the procedure, however, has not yet been proved.
It is not at all clear to me what clinical indications were present in the patients of Dotter and his associates: how many of the patients had only claudication, how many had pain at rest or gangrene, and if either of the last two were present, what was the extent of disease?
From the authors' description, dilatation was done on two types of occlusive lesions: (1) lesions in which the stenosis was longer than 1 cm and (2) lesions in which the stenosis was short and "shelf-like." How much longer than 1 cm were the iliac stenoses? Did they extend into
Whelan TJ. Transluminal lliac Artery Dilation— Dotter's Method; Caution Advised. JAMA. 1974;230(1):91–92. doi:10.1001/jama.1974.03240010059037
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