We thank Dr Kaufman for his interest in our article and for the favorable comments he has concerning the uses of interventional radiological procedures in the treatment of atherosclerotic peripheral vascular disease. We have attempted to outline the indications for arteriography in these patients, which at The Johns Hopkins Hospital, Baltimore, Md, do include failure of a strict walking program to alleviate severe life-style-altering claudication as well as symptoms of acute arterial occlusion such as loss of distal pulse rates, pallor with a cold extremity, and neurological changes. We certainly agree with Dr Kaufman that symptomatology, the presence of ischemic skin changes, and severely decreased pulse pressures as demonstrated by Doppler recordings aid in the identification of patients who will best benefit from therapeutic procedures.We concur with Dr Kaufman about the use of percutaneous transluminal balloon angioplasty in the management of patients in a limb-salvage situation, as
Widlus DM, Osterman FA. Interventional Procedures in Peripheral Atherosclerotic Disease-Reply. JAMA. 1989;262(17):2388. doi:10.1001/jama.1989.03430170047024
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