LIMB SALVAGE BY PERCUTANEOUS TRANS-LUMINAL RECANALIZATION OF THE OCCLUDED SUPERFICIAL FEMORAL-ARTERY

Abstract

Six patients with rest pain and gangrene or ulceration were treated by percutaneous transluminal angioplasty using the Gruentzig balloon catheter. All had superficial femoral artery occlusion with severe stenosis or occlusion of the popliteal and tibial arteries. Two patients had previous distal bypass procedures which had failed, and none was a candidate for arterial reconstruction. The superficial femoral artery was recanalized in 5 patients with an increase in the above-knee pressure index from 0.5 .+-. 0.1 to 1.0 .+-. 0.1 (P < 0.001) and ankle pressure index from 0.2 .+-. 0.1 to 0.5 .+-. 0.1 (P < 0.001). All 5 patients avoided early amputation and were able to ambulate when discharged. The 6th patient could not be recanalized and required above-knee amputation. Restenosis of the recanalized superficial femoral artery occured in 4 patients 2-5 mo. later, and repeat transluminal angioplasty was successful in 3 patients. Two patients have required below-knee amputation 4 and 5 mo. after recanalization. Transluminal angioplasty can extend our capability of early limb salvage.