Endoluminal angioplasty of the popliteal artery. Review of 54 consecutive patients.

Aim: To determine the results of endoluminal angioplasty for occlusive or stenotic lesions of the popliteal artery.

Methods: Retrospective study of symptomatic patients having popliteal occlusive lesions treated by endoluminal balloon angioplasty. All patients underwent systematic preoperative and postoperative color duplex scan and preoperative angiography. The principal endpoints were primary and primary assisted patency.

Results: Fifty-four percutaneous endoluminal angioplasties of the popliteal artery, including six procedures with stents, were performed in 50 patients. In all cases, the superficial femoral artery was patent and without significant stenosis. Primary patency for the entire cohort was 57.4+/-6.7% at 1 and 2 years. Primary assisted patency was 86.3+/-4.8% at 1 year, and 79.1+/-5.9% at 2 years. The results of angioplasty appeared to be better in patients with intermittent claudication when compared to patients with critical limb ischaemia, (p=0.0006). Angioplasty of single occlusive lesions had a better prognosis than that of multiple occlusive lesions (p=0.01). Results of angioplasty were better at the below-knee and median popliteal artery than at the femoro-popliteal junction or in the above-knee popliteal artery (p=0.03). Tibial run-off and isolated popliteal stenosis versus isolated popliteal thrombosis did not seem to affect primary patency rate.

Conclusion: Results of angioplasty of the popliteal artery are acceptable for claudicants, especially those with TASC-A lesions and those with lesions in the distal two thirds of the popliteal artery.