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Transluminal angioplasty (TLA) has been used in six patients with subclavian artery stenosis admitted to a large community hospital. Five patients had lesions proximal to the origin of the left vertebral artery, three of whom had angiographic evidence of subclavian steal syndrome. In all six, arteries were successfully dilated with only one complication of a hematoma at an arteriotomy site. In a 10 to 24-month follow-up, all six patients have remained totally asymptomatic without any further complications. [ABSTRACT FROM AUTHOR]

Thermal laser angioplasty (TLA) experience of 59 hospital cases in 1988 (Group A) was compared with 113 outpatient cases treated from March 1989 to September 1991 (Group B). Angiographic success was higher in Group B (66.4%) as compared with Group A (55.9%). Complications of major dissection, perforation, and local thrombus were similar. Distal emboli (P=0.04), retroperitoneal hematomas (P=0.02), and urokinase administration (P=0.03) were more prevalent in Group A. At follow-up (six to thirty-six months), 57% of Group B patients were symptom free but only 36 of Group A were. Symptomatic improvement, despite recurrence of intermittent claudication (IC), was present in 21% of group A and 6% of Group B subjects. Though unpredictable, the mean ankle/arm indices were found in the following clinical categories: 100% reocclusion by angiography, 0.46; IC same as before TLA, 0.56; IC with mild-marked improvement, 0.70%; asymptomatic, 0.94. Average length of lesion-Group A, 10.5 cm versus Group B, 17 cm.This review does show improved primary success rates with further operator experiences despite tackling of more difficult lesions. The reduction in complications is related to the decreased use of urokinase and the availability of trained support personnel. [ABSTRACT FROM PUBLISHER]

Thermal laser angioplasty (TLA) experience of 59 hospital cases in 1988 (Group A) was compared with 113 outpatient cases treated from March 1989 to September 1991 (Group B). Angiographic success was higher in Group B (66.4%) as compared with Group A (55.9%). Complications of major dissection, perforation, and local thrombus were similar. Distal emboli (P=0.04), retroperitoneal hematomas (P=0.02), and urokinase administration (P=0.03) were more prevalent in Group A. At follow-up (six to thirty-six months), 57% of Group B patients were symptom free but only 36 of Group A were. Symptomatic improvement, despite recurrence of intermittent claudication (IC), was present in 21% of group A and 6% of Group B subjects. Though unpredictable, the mean ankle/arm indices were found in the following clinical categories: 100% reocclusion by angiography, 0.46; IC same as before TLA, 0.56; IC with mild-marked improvement, 0.70%; asymptomatic, 0.94. Average length of lesionGroup A, 10.5 cm versus Group B, 17 cm. This review does show improved primary success rates with further operator experiences despite tackling of more difficult lesions. The reduction in complications is related to the decreased use of urokinase and the availability of trained support personnel. [ABSTRACT FROM AUTHOR]

Total occlusion of a right femoropopliteal reinforced Dacron bypass graft in a 75-year-old man was manifested by at rest right calf and foot pain. The patient was treated using a combination of percutaneous transluminal angioplasty (PTA) with streptokinase infusion. The graft was reopened and dilated successfully, resulting in total abatement of the patient's symptoms. Percutaneous transluminal angioplasty may be an important alternative in treatment of patients with occluded bypass grafts. [ABSTRACT FROM AUTHOR]