Freedom from secondary interventions to treat stenotic disease after percutaneous transluminal angioplasty of infrarenal aorta: long-term results.

PURPOSE

The purpose of this study was to determine the long-term results (1-15 years) of percutaneous transluminal angioplasty (PTA) of localized atherosclerotic lesions of the infrarenal aorta.

METHODS

This was a retrospective study. From January 1987 to January 2002, 69 patients underwent PTA of an isolated stenosis of the lower abdominal aorta under local anesthesia in the department of interventional radiology. All atherosclerotic lesions were hemodynamically significant, defined as a subjective report of walking distance less than one block, resting pain, or trophic changes in combination with diameter reduction of 50% or greater at duplex ultrasound scanning and angiography.

RESULTS

The female-male ratio of study patients was 3.6:1; mean age was 58 years. Endovascular treatment was initially technically and clinically successful in all but one patient (98%), who had a near total occlusion. No major complications were noted. Mean follow-up was 57 months (range, 6 months-15 years). At life table analysis, 5-year primary patency was 75%, and secondary patency was 97%. Twelve patients (17%) required repeat interventions because of hemodynamically significant recurrent stenosis in combination with severe clinical symptoms. Most recurrent stenoses (67%) were successfully treated with repeat endovascular procedures.

CONCLUSIONS

Early and long-term results of PTA (with additional stent placement) of isolated stenosis of the infrarenal aorta are good. This minimally invasive procedure is a true alternative to traditional surgical methods.