Clinical Results Analysis Of Percutaneous Transluminal Angioplasty For Arteriosclerosis Obliterans

Objective:To evaluate the clinical results of infragenicular percutaneous transluminal angioplasty (PTA) in the treatment of arteriosclerosis obliterans.Material and Method:This study retrospectively analyzed 71 patients (101 limbs) with infrapopliteal artery ischemia treated at vascular surgery department of the First Affiliated Hospital of Fujian Medical University from Feb 2009 to Mar 2010. The patients are divided into two groups according to their therapy: Group II with PTA treatment; Group II with only drug treatment. Two groups were compared according to their clinical features, including age, gender, course of disease, symptoms, limp distance, risk factor, ABI, ABI increment and clinical results after treatment, etc. Statistical analysis was performed with a significance difference level defined at P<0.05.Results:45 of 71 patients (52 limbs) were selected under Group I, while the rest 26 patients (49 limbs) were under Group II. The patients ranged from 39 to 86 years old (average 70.39±1.09), with 49 male and 22 female cases. No significance difference in age and gender between two groups was observed (P>0.05). The clinical results of Group I shows: 55.77% as"significantly improved", 34.62% as"improvement", 9.62% as"no change"; while Group II shows: 0% as"significantly improved", 20.41% as"improvement", 79.59% as"no change"; no worse condition was observed in both groups. There was significant difference between two groups, while Group I exhibited better clinical results than Group II. Group I and II had an average of pre-therapy ABI of 0.34±0.04, and 0.46±0.05 respectively. One week later, ABI of Group I and II had increased to 0.86±0.03 and 0.50±0.04, respectively, both showing significant difference compared to pre-therapy (P<0.05). For Group I patients, the average ABI had increased 0.52±0.04, which is much higher compared to Group II of 0.04±0.01. After 6 months, the average ABI were 0.80±0.03 and 0.48±0.04 for Group I and II respectively, still showing significant difference. For group I, no patient died in the therapy period. The patients exhibited post-operative complications were 7.69% and the limb salvage rate was 100%.Conclusion:1. PTA is feasible, safe and effective in treating critical infragenicular limb ischemia.2. Clinical recurrence of infrapopliteal PTA was infrequent and the procedure could successfully be repeated in most cases.PTA should be recommended as the first choice for patients with critical infragenicular limb ischemia.3. With regard to patients whom suffering from infragenicular limb ischemia, PTA is an effective therapy with minimal invasion. However, as to the long term patency, further study has to be done to investigates its effect in the future.