The role of transluminal angioplasty in limb salvage and claudication.

With the introduction of the Griintzig balloon catheter, percutaneous transluminal angioplasty has gained increased acceptance and has been used to dilate lesions in the coronary [7], renal [6, 91, mesenteric [41, aorta [5], iliac [ 11, femoral [3] and popliteal [3] arteries. In lower extremity ischemia it has been used primarily to treat patients with claudication and short segmental lesions [8] with relatively poor success in limb salvage situations with long segment obstruction and poor runoff [8, 121. Because of a high initial success rate and low complication rate [8], the procedure has been used, at times, in patients with minimal symptoms who otherwise would not be considered for operation. However, objective documentation of the results of transluminal angioplasty and long-term follow-up have been lacking. In order to evaluate the procedure and help develop proper patient selection criteria, we recorded lower extremity systolic blood pressure indices before and after transluminal angioplasty in two groups of patients who were not candidates for operative revascularization. In one group were patients with claudication who had surgically correctable lesions, but did not undergo operation because they declined operation or were felt to have symptoms that were not severe enough to warrant operation. In the other group