The role of balloon angioplasty in the management of lower limb ischaemia

Three hundred and twenty-three angioplasties (159 iliac; 164 femoro-popliteal) were performed for lower limb ischaemia on 253 consecutive patients from 1980–86. The mean resting ankle/brachial pressure index (ABPI) was increased at one month in open angioplasties as follows: Femoro-popliteal 0.56–0.82; iliac with open superficial femoral artery (SFA) 0.7–0.95; iliac with occluded SFA 0.52–0.63. Successful angioplasty virtually abolished the post-exercise fall in ABPI except for patients having iliac dilations when multisegment disease was present. At 5 years, cumulative patency was 72% for iliac angioplasty and 53% for femoro-popliteal angioplasty. The results of angioplasty were compared with operative arterial reconstructions during 1985. Eighty-eight (91%) of 96 surgical bypasses were alive and patent at hospital discharge and 44 (71%) of 62 angioplasties were patent at 1 month. There were many fewer complications with angioplasty which involved a much shorter hospital stay (2 days vs 16 days).