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Vol 13, No 2 (2011)
Published online: 2012-04-27

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Safety and immediate results of endovascular treatment of peripheral arterial occlusive disease (PAOD) — a prospective evaluation. Analysis of data collected in the Małopolska Endovascular Registry

Andrzej Belowski, Marek Krzanowski
Chirurgia Polska 2011;13(2):98-106.

Abstract

Background: To provide data on safety and immediate effects of endovascular treatment of PAOD which may be used to work out the best approach to invasive treatment of this disease in our country.
Material and methods: All data were collected prospectively in the Malopolska Endovascular Registry. There were 763 procedures performed between Dec. 1, 2009 and June 31, 2010. The indication for treatment was leg ischemia Rutherford stage 6 in 77 cases (10.1%), stage 5 in 173 cases (22.7%), stage 4 in 123 cases (16.1%), stage 3 in 371 cases (48.6%) and stage 2 in 19 cases (2.5%).
Results: Overall, an increase in blood supply to the treated leg was seen in 97.5% of procedures while deterioration was noted in only 0.5% of cases. The worst results were obtained in the procedures performed on infrapopliteal vessels — there was a 4.6% rate of bad results (defined as no increase in blood flow or a deterioration of flow to the treated leg upon completion of endovascular treatment). Major complications were seen in 0.8% of procedures: 1 ischemic stroke, 2 acute coronary syndromes were noted, one patient was emergently operated on due to stent misplacement and 2 patients developed acute pulmonary edema. There were no deaths and no amputations. Moderate severity complications were seen in 3.7% of procedures and mild complications in 16.6%. The frequency of complications was significantly greater in CLI patients in comparison to non-CLI patients, but the number of severe and moderate severity complications was quite low.
Conclusions: Endovascular treatment of PAOD is safe and the immediate results are very good. The referral of claudicants for endovascular treatment may be justified provided the long term effects of percutaneous treatment are favorable. Comparison with the results of surgical therapy may serve to work out the best treatment strategy of patients with chronic lower leg ischemia.

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Chirurgia Polska (Polish Surgery)