Femoropopliteal Angioplasty

Factors Influencing Long-term Success

Capek, Paul MD
McLean, Gordon K. MD
Berkowitz, Henry D. MD

From Radiologic Associates, Sutter Hospitals, Sacramento, Calif.; the Department of Radiology, The Western Pennsylvania Hospital, Pittsburgh; and the Department of Surgery (H.D.B.), Hospital of the University of Pennsylvania, Philadelphia, Pa.

Address for reprints: Gordon K. McLean, MD, Chief of Angiography and Interventional Radiology, Department of Radiology, The Western Pennsylvania Hospital, 4800 Friendship Avenue, Pittsburgh, PA 15224.

Circulation 83(2):p I70-I80, February 1991.

Prospective data was recorded on 217 percutaneous transluminal angioplasty (PTA) procedures performed in the superficial femoral and popliteal arteries over an 8-year period. After the initial procedure, patients were followed with serial noninvasive studies and, in 71 patients, repeat angiography. The mean follow-up period was 7 years (range, 2-11 years). Standard life-table survival analysis was used to assess the factors potentially affecting long-term outcome. Excluding an initial technical failure rate of 10%, overall patencies at 1, 3, and 5 years were 81%, 61%, and 58%, respectively. After the first year, the prognosis (i.e., failure rate) appears to be linear over the long term (i.e., up to 10 years). Factors negatively influencing longterm patency include the presence of diabetes mellitus, diffuse atherosclerotic cardiovascular disease, or threatened limb loss. Technical factors correlated with failure include lesion length, moderate eccentricity, and a poor post-PTA appearance. (Circulation 1991;83[suppl 11:I-70–I-80)