Femoropopliteal angioplasty. Factors influencing long-term success.

TLDR

The study prospectively followed 217 percutaneous transluminal angioplasty procedures in the superficial femoral and popliteal arteries over eight years, with a mean 7‑year follow‑up using serial noninvasive imaging, repeat angiography in 71 patients, and life‑table survival analysis to evaluate long‑term outcomes. Patency rates were 81 %, 61 %, and 58 % at 1, 3, and 5 years, respectively, with a linear decline thereafter; long‑term failure was associated with diabetes, diffuse atherosclerosis, threatened limb loss, lesion length, moderate eccentricity, and poor post‑PTA appearance.

Abstract

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 long-term 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.