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October 1983

Limb Salvage in Poor-Risk Patients Using Transluminal Angioplasty

Author Affiliations

From the Departments of Surgery (Drs Rush, Gewertz, and Zarins) and Radiology (Drs Lu and Ball), University of Chicago, Pritzker School of Medicine. Dr Rush is now with the Department of Surgery, Tulane University School of Medicine, New Orleans. Dr Gewertz is a Teaching Scholar of the American Heart Association.

Arch Surg. 1983;118(10):1209-1212. doi:10.1001/archsurg.1983.01390100071018

• We performed percutaneous transluminal angioplasty (PTA) in 97 limbs of 86 patients with end-stage occlusive disease in whom vascular reconstruction was not possible. Most patients required dilation of long-segment occlusions and/or multiple lesions. Angiographic appearance was improved in 87 limbs of 78 patients (90%). Ankle-brachial pressure index increased from 0.40±0.03 to 0.64±0.03, and increased more than 0.15 in 63% of the limbs. Major amputation was required in 19 of the 87 limbs (22%) following PTA. The incidence of restenosis was 19% at three months, 42% at six months, and 57% at one year. Repeated PTA successfully maintained vascular patency in ten limbs, and four patients have since had successful distal bypass. Two limbs that initially improved needed amputation four to 19 months after dilatation. Follow-up ranged from one to 45 months; overall limb salvage rate was 76%. Thus PTA can enhance limb salvage in poor-risk patients with end-stage disease.

(Arch Surg 1983;118:1209-1212)