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Correlates of Clinical Success

Richard P. Cambria, MD; Glen Faust, MD; Richard Gusberg, MD; M. David Tilson, MD; Karl A. Zucker, MD; Irvin M. Modlin, MD

Arch Surg. 1987;122(3):283-287.

Abstract
• We reviewed 142 percutaneous transluminal angioplasties (PTAs) in the iliac (n = 94) and femoropopliteal (n = 48) positions of 107 patients. Emphasis was placed on the ultimate clinical outcome, which was determined from a pool of clinical, hemodynamic, and angiographic data. Limb-threatening ischemia was the indication for intervention in 53% of the cases. The median follow-up interval was 17 months. Overall success was achieved in 50% of cases in both iliac and femoral positions at one year after PTA. The following factors were found to correlate with a successful clinical outcome: (1) PTA for claudication vs limb-threatening ischemia (P<.001); (2) focal as opposed to diffuse stenosis or occlusion (P<.02); (3) immediate return of distal pulses (P<.001); (4) the absence of diabetes (P<.05); and (5) the presence of a patent outflow tract (P<.001). Treatment results with PTA will vary widely according to the nature of the patient population and the criteria for determining success.

(Arch Surg 1987;122:283-287)

Author Affiliations
From the Divisions of Vascular Surgery, West Haven Veterans Administration Medical Center and the Yale—New Haven Hospital, New Haven, Conn; and the Department of Surgery, Yale University School of Medicine, New Haven.

Footnotes
Accepted for publication Dec 30, 1986.

Read before the Tenth Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Washington, DC, May 9, 1986.

Reprint requests to Massachusetts General Hospital, 15 Parkman St, Boston, MA 02114 (Dr Cambria).

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