Abstract

Purpose : The purpose of this study was to determine the safety and efficacy of the percutaneous transluminalangioplasty(PTA) in patients with chronic arterial occlusive disease below the knee joint. Materials and Methods :We retrospectively analyzed the results of 36 procedures in 16 patients. There were 15 men and one woman, aged57-75 years(mean, 62 years). Indications were disabling claudication(SVS/ISCVS grade 1, category 3) in five cases,rest pain(grade 2, category 4) in three cases, and non-healing ulceration or gangrene(grade 3, category 5) ineight cases. PTA was performed by using small vessel balloon catheter of 2-4 mm and 3 mm monorail balloon catheterin tibioperoneal vessels and 5-6 mm balloon catheter in distal popliteal artery and tibioperoneal trunk. Combinedthrombolytic therapy with Urokinase was performed in 14 patients. Results : Involved infrapopliteal vessels werefour distal popliteal arteries, 15 tibioperoneal trunks, six anterior tibial arteries, five posterior tibialarteries, and seven peroneal arteries. Technical success was determined when post-PTA angiogram showed less than30% of residual stenosis. Clinical success was defined as improvement of clinical symptoms, such as disappearanceof claudication or rest pain, and healing of ulceration. Technical success was achieved in 30 of 36 arteries(83%).Clinical success was achieved in 12 of 16 patients(75%) at an average follow-up of 13.3 months(range, 2-46months). Clinical success rate was 100% in grade 1 category 3 patients, 67% in grade 2 category 4 patients, and63% in grade 3 category 5 patients. Complication included two distal emboli, one vessel rupture, one vesselthrombosis, and one occluding intimal flap. Conclusion : PTA was an effective method for treatment of chronicarterial occlusive disease below the knee joint and considered as the procedure of first choice. Severeclaudicant(grade 1) should be included in the indication of the tibioperoneal PTA.

주제어

#Arteries, extremities   #Arteries, transluminal angioplasty  

저자의 다른 논문

참고문헌 (23)

1. Femoral, popliteal, and tibial arteries:percutaneous transluminal angioplasty , Greenfield AJ , AJR / v.135,pp.927-935, 1980
   
2. Arterial occlusive disease below the knee:treatment with percutaneous transluminal angioplasty performed with low-profile catheters and steerable guidewire , Schwarten DE;Cutcliff WB , Radiology / v.169,pp.71-74, 1988
   
3. liteal angioplasy:long term follow-up , J Vasc Interv Radiol / v.4,pp.139-144, 1993
   
4. Chronic critical lower limb ischemia:prospective trial of angioplasty with 1-36 months follow-up , Matsi PJ;Manninen HI;Suhonen MT;Pirinen AE;Soimakallio S , Radiology / v.188,pp.381-387, 1993
   
5. Restenosis and successful angioplasty:histologic-radiologic correlation , Roeren T;LeVeen RF;Villanueva T;Reisman J , Radiology / v.172,pp.971-977, 1989
   
6. Percutaneous transluminal angioplasty for lower limb ischemia , Campbell WB;Jeans WD;Cole SEA;Baird RN , Br J Surg / v.70,pp.736-739, 1983
   
7. 폐쇄성 혈관질환에 대한 혈전용해혈관성형술의 유용성 , 정태웅;김재규;고병관;김진엽;서정진;강형근 , 대한방사선의학회지 / v.29,pp.954-956, 1993
   원문보기 상세보기
8. Percutaneous transluminal angioplasty of the infrapopliteal arteries , Bakal CW;Sprayregen S;Scheinbaum K;Cynamon J;Veith FJ , AJR / v.154,pp.171-174, 1990
   
9. Prospective randomized multicenter comparison of in situ and reversed vein infrapopliteal bypasses , Wengerter KR;Veith FJ;Gupta SK(et al) , J Vasc Surg / v.13,pp.189-199, 1991
   
10. Percutaneous transluminal angioplasty of crural arteries , Hovarth W;Oerti M;Haidinger D , Radiology / v.177,pp.565-569, 1990
    
11. Resurrection of the in-situ saphenous vein bypass 1000 cases later , Leather RP;Shah DM;Chang BB;Kaufman JL , Ann Surg / v.208,pp.435-442, 1988
    
12. Percutaneous transluminal angioplasty of infrapopliteal vesseles:preliminary results and technical consdierations , Brown KT;Schoenberg NY;Moore ED;Saddekni S , Radiology / v.169,pp.75-78, 1988
    
13. Percutaneous transluminal angioplasty below the knee:new techniques, excellent results , Casarella WJ , Radiology / v.169,pp.271-272, 1988
    
14. Distal popliteal and tibioperoneal transluminal angioplasy:long term follow-up , Bull PG;Mendel H;Hold M(et al) , J Vasc Interv Radiol / v.3,pp.45-53, 1992
    
15. Fate of patients undergoing transluminal angioplasty for lower limb ischemia , Jeans WD;Armstrong S;Cole SEA;Horrocks M;Baird RN , Radiology / v.177,pp.559-564, 1990
    
16. A comparison of in situ and reversed saphenous vein grafts for infrainguinal reconstruction , Fogle MA;Whittemore AD;Couch NP;Mannick JA , J Vasc Surg / v.5,pp.46-52, 1987
    
17. Transluminal treatment of arteriosclerotic obstruction:description of a new technique and a preliminary report of its application , Dotter CT;Judkins MP , Circulation / v.30,pp.654-670, 1964
    
18. 하지부 경피경관 혈관성형술 , 장병원;서경진;김태헌;박인규;김용주;강덕식 , 대한방사선의학회지 / v.23,pp.40-47, 1987
    원문보기 상세보기
19. 동맥경화성 폐쇄성 혈관질환의 경피경관 혈관성형술 , 정용연;류인훈;성정진등 , 대한방사선의학회지 / v.27,pp.656-661, 1991
    원문보기 상세보기
20. Arterial stent placement with use of the Wallstent:midterm results of cllinical experience , Zollikofer CL;Antonucci F;Pfyffer M(et al) , Radiology / v.179,pp.449-456, 1991
    
21. Standards for evaluating and reporting the results of surgical and percutaneous therapy for peripheral arterial disease , Rutherford RB;Becker GJ , J Vasc Interv Radiol / v.2,pp.169-174, 1991
    
22. Bypass operations to the infrapopliteal arteries and their terminal branches , Ascer E;Gennaro M;Strandness DE(ed.);van Breda A(ed.) , Vascular diseases(1st ed) / v.,pp.501-509, 1994
    
23. Popliteal artery branches:percutaneous transluminal angioplasty , Sprayregen S;Sniderman KW;Sos TA;Vieux U;Singer A;Veith FJ , AJR / v.135,pp.945-950, 1980
    

이 논문을 인용한 문헌 (0)

1. 이 논문을 인용한 문헌 없음