Evaluating the Success of Endovascular Treatment in Patients with Peripheral Artery Disease

Abstract

Background: Atherosclerosis is a systemic disease of large- and medium-sized arteries in which the diameter of the artery is narrowed due to accumulation of fat and fibrous materials between the intima and medial layers of the vessels. Atherosclerosis of non-cardiac arteries is called Peripheral Artery Disease (PAD). Although endovascular treatments demonstrated high success rates, treatment failure is still regarded as a great concern. Therefore, the purpose of this study was to evaluate the success rates and risk factors of Percutaneous Transluminal Angioplasty (PTA) in patients with PAD.<br />Methods: In this retrospective cohort study, the medical records of all the patients referring to Shariati Hospital and Tehran Heart Center with complaints of severe claudication, treated via PTA during 2007-13 were collected from the archives. Required data were extracted from the records and then were analyzed by SPSS software V24.<br />Results: Of the 111 patients included in this study, 2 underwent PTA three times. Two PTAs were performed on 17 subjects and the rest only had one PTA. Based on the results, the first PTA in 96 patients (86.5%) was successful, in 12 subjects (10.8%) was acceptable and in three cases was unsuccessful. Considering the acceptable results as successful, a success rate of 97.3% was calculated. It was revealed that 17 subjects needed a second PTA which is indicative of a 15.7% re-stenosis rate. According to the analysis performed to identify the risk factors of treatment failure, the differences regarding length of the lesion (p<0.001) and serum HDL level (p=0.005) were statistically significant.<br />Conclusion: The success rate of PTA for treatment of PAD was found to be considerably high which promotes its application as the treatment of choice. However, the risk factors identified in this study seem to be accidental findings due to a small sample size of patients in one of our comparison groups.<br /><br />