The influence of surgical insults on restenosis after transluminal balloon angioplasty.

The influences of atherogenic response on restenosis after transluminal balloon angioplasty and the anastomosis of arterial reconstruction were investigated. Iliac transluminal balloon angioplasty was performed on 81 consecutive patients at 86 sites, between January, 1987 and December, 1992. A balloon angioplasty alone was performed in 58 patients at 60 sites, while distal revascularization was performed in 23 patients on 26 limbs, in association with the angioplasty. An improvement in the inflow of the distal grafts was achieved in 22 of these 23 patients in 26 limbs. The combined distal revascularization included 21 femoropopliteal bypasses, 3 femorofemoral bypasses, and 2 thromboendarterectomies at the profunda femoris arteries. A reduction in the luminal diameter after the balloon angioplasty was determined by means of follow-up arteriograms which showed no obvious progression of the restenosis at the angioplasty sites even when neointimal hyperplasia had developed at the anastomosis of the arterial reconstruction. The accumulative graft patency rate of the combined distal revascularization did not differ significantly from that of femoropopliteal reconstructions alone during the same study period. This study demonstrated that concomitant surgical insults do not have a detrimental effect on restenoses at angioplasty sites.