ATP Femoropoplítea en pacientes claudicantes*

Información del artículo

Resumen

Objetivos

Valoración de los resultados a corto, medio y largo plazo de la Angioplastia Transluminal Percutánea (ATP) femoropoplítea en pacientes con isquemia crónica MsIs en grado II.

Pacientes y métodos

Estudio retrospectivo de 28 pacientes seleccionados por estenosis significativas u obstrucciones cortas (< 3cm) del sector femoropoplíteo, claudicantes, sometidos a ATP sobre 35 extremidades entre 1992 y 1997. (21 hombres-7 mujeres; Edad media 66 aíos).

Analizamos factores de riesgo, aspecto angiográfico pre y postprocedimiento, permeabilidad del procedimiento a 6, 14, 18, 32, 46 y 62 meses determinada por valoración clínica, funcional y Eco-doppler en el último año.

Resultados

Exito inicial en el 100% de los procedimientos, valorado por arteriografía post-ATP, clínica e índice T/B.

Complicaciones menores en 3 casos.

La permeabilidad fue analizada mediante tabla de supervivencia de Kaplan-Meier con los siguientes resultados: Permeabilidad primaria del 85.3%, 73.1%, 70.1%, 60.9%, 51.4% y 41.1% a 6, 14, 18, 32, 46 y 62 meses respectivamente. Permeabilidad asistida del 54,37% a 62 meses. Fueron necesarias 7 re ATP, 4 en los primeros 6 meses, 1 a los 12 meses y 2 a los 48 meses.

Conclusiones

La ATP en pacientes claudicantes de este sector puede ser beneficiosa en casos muy seleccionados por sus buenos resultados de permeabilidad a largo plazo. La clínica de claudicación reaparece en caso de obstrucción o reestenosis marcada.

Palabras clave:

Angioplastia Transluminal Percutánea (ATP)

claudicación intermitente

sector femoropoplíteo

Summary

Objetives

Valuation of Percutaneus Transluminal Angioplasty (PTA) femoropopliteal in patients with chronic ischaemia of lower limbs in degree II.

Patients and methods

Retrospective study of 28 patients selected by significant stenosis or short occlusions (< 3cm) of femoropopliteal sector, claudicants, to PTA on 35 extremities between 1992 and 1997. (21 men-7 women; Half age 66 years).

We analyze factors of risk, angiographic aspect before and after PTA, permeability of the procedure at 6, 14, 18, 32, 46 and 62 months determined by clinical, funtional valuation and Echo-doppler in the last year.

Results

Initial success in 100% of the procedures, valued by angiography after PTA, clinic and index T/B. Smaller complications in 3 cases.

The permeability was analyzed by means of chart of survival of Kaplan-Meier with the folloxoing results: Primary permeability of 85.3%, 73.1, 70.1%, 60.9%, 51.4% and 41.1% at 6, 14, 18, 32, 46 and 62 months respectively. Attended permeability of 54.37% to 62 months. They were necessary 7 rePTA, 4 in the first 6 months, 1 at the 12 months and 2 to the 48 months.

Conclusions

PT A in patients halting of this sector, it can be beneficial in cases very selected by their long term good permeability results. In case of re-stenosis or occlusions, claudication will return.

Key words:

PTA

intermitent claudication

femoropopliteal disease

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Bibliografia

[1.]

Reilly D.T., Packer S.G., Morrison N., Van Rij A.M..

Percutaneous transluminal angioplasty for the ischaemic lower limb: the early Dunedin experience.

N. Z. Med. J., 101 (1988), pp. 129-132

Medline

[2.]

Creasu T.S., Macmillan P.J., Fletcher E.W., Collin J., Morris P.J..

Is percutaneous transluminal angioplasty better than exercise in claudication? Preliminary results from a prospective randomized trial.

Eur. J. Vasc. Surg., 4 (1990), pp. 135-140

Medline

[3.]

Van Rij A.M., Packer S.G., Morrison N..

A randomized controlled study of PTA for claudicants with femoropopliteal disease.

J. Cardiovasc. Surg., (Torino), 32 (1991), pp. 34

[4.]

Escudero J.R., Augé J., Llagostera S., García Madrid C., Mestres J.M., Lloret M.D., et al.

Angioplastia transluminal percutánea asistida con laser (PTLA). Cinco años de experiencia.

Angiologia, 4 (1994), pp. 135-138

[5.]

Perkins J.M.T., Collin J.C., Creasy T.S., Flet-Cher E.W., Morris P.J.M..

Exercise training versus angioplasty for stable claudication: Long and medium-term results of a prospective, randomized trial.

Eur. J. Vasc. Endovasc. Surg., 11 (1996), pp. 409-413

Medline

[6.]

Whyman M.R., Fowkes F.G.R., Kerracher E.M.G., Gillespie I.N., Lee A.J., Housley E., et al.

Is intermitent claudication improved by percutaneous transluminal angioplasty? A randomized controlled trial.

J. Vasc. Surg., 26 (1997), pp. 551-557

Medline

[7.]

Jensen L.P..

Intermittent claudication. Conservative treatment, endovascular repair or open surgery for femoropopliteal disease.

Ann. Chir. Gynaecol., 87 (1998), pp. 137-140

Medline

[8.]

Ramaswami G., Tegos T., Nicolaides A.N., Dhanjil S., Griffin M., Alkutobi A., et al.

Ultrasonic plaque character and outcome after lower limb angioplasty.

J. Vasc. Surg., 29 (1999), pp. 110-121

Medline

[9.]

Currie I.C., Wakeley C.J., Cole S.E.A., Wyatt M.G., Scott D.J.A., Baird R.N., et al.

Femoropopliteal Angioplasty for severe limb ischaemia.

Br. J. Surg., 81 (1994), pp. 191-193

Medline

[10.]

Gray B.H., Sullivan T.M., Childs M.B., et al.

High incidence of restenosis/reocclusion of stent in the percutaneus treatment of long-segment superficial femoral artery disease after suboptimal angioplasty.

J. Vasc. Surg., 25 (1997), pp. 74-83

Medline

[11.]

Porter J.M..

Endovascular.

Year Book Of Vascular Surgery, pp. 110-111

[12.]

Nyamekye I., Sommerville K., Raphael M., et al.

Non-invasive assessment of arterial stenoses in angioplasty surveillance: A comparison with angiography.

Eur. J. Vasc. Surg., 12 (1996), pp. 471-481

[13.]

Whyman M.R., Fowkes F.G.R., Kerracher E.M.G., Gillespi I.N., Lee A.J., Housley E., et al.

Randomized controlled trial of percutaneus transluminal angioplasty for intermitent claudication.

Eur. J. Vasc. Endovasc. Surg., 12 (1996), pp. 167-172

Medline

[14.]

Fuster V..

Estabilización de la placa: Situación actual y tendencias futuras.

La placa de ateroma vulnerable, pp. 307-322

[15.]

Boccalon H..

Intermittent claudication in older patiens. Practical treatment guidelines.

Drugs Aging., 4 (1999), pp. 247-259

[16.]

O'Donohoe M.K., Sultan S., Colgan M.P., Moore D.J., Shanik G.D..

Outcome of the first 100 femoropopliteal angioplasties performed in the operating theatre.

Eur. J. Vasc. Endovasc. Surg., 17 (1999), pp. 66-71

Medline

[17.]

Golledge J., Ferguson K., Ellis M., Sabharwal T., Greenhalgh R.M., Powell J.T..

Outcome of femoropopliteal angioplasty.

Ann. Surg., 229 (1999), pp. 146-153

Medline

[18.]

Nicholson T..

Percutaneus transluminal angioplasty and enclosed thrombolysis versus percutaneus transluminal angioplasty in the treatment of femoropopliteal occlusions: results of a prospective randomized trial.

Cardiovasc. Intervent. Radiol., 21 (1998), pp. 470-474

http://dx.doi.org/10.1007/s002709900306 | Medline

[19.]

Nydahl S., Hartshorne T., Bell P.R.F., et al.

Subintimal Angioplasty of infrapopliteal occlusions in critically ischaemic limbs.

Eur. J. Vasc. Endovasc. Surg., 14 (1997), pp. 212-216

Medline

[20.]

Alback A., Biancari F., Schmidt S., MikkolA P., Kantonen I., Matzke S., et al.

Haemodynamic results of femoropopliteal percutaneous transluminal angioplasty.

Eur. J. Vasc. Endovasc. Surg., 16 (1998), pp. 7-12

Medline

[21.]

Vroegindeweij D., Tielbeek A.V., Buth J., Vos L.D., Van Den Bosch H.C..

Patterns of recurrent disease after recanalization of femoropopliteal artery occlusions.

Cardiovasc. Intervent. Radiol, 20 (1997), pp. 257-262

Medline

Comunicación presentada en las XLVI Jornadas Angiológicas Españolas, Barcelona (España), 2000.

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