Long-Term Results of Iliac and Femoropopliteal Angioplasty

Abstract

Transluminal angioplasty of the peripheral arteries using the Grüntzig balloon catheter has been performed at the Toronto General Hospital since 1978. The method used is the same as that originally described by Grüntzig except that almost all stenoses, and some obstructions, are initially passed with a curved catheter rather than the guide wire. All patients receive acetylsalicylic acid 600 mg (lately reduced to 300 mg) and dipyridamole 50 mg three times a day beginning 3 days before the procedure and continuing for 2–3 weeks after. An intraarterial injection of 5,000 units heparin is given during the procedure but no long-term anticoagulant therapy is used. However, no heparin has been administered during the last 34 iliac dilatations in an attempt to reduce the incidence of hematoma formation at the puncture site. No increase in the incidence of early reocclusion has been noted in this group of patients. Heparin is still used during femoropopliteal angioplasty to prevent thrombus formation related to the stasis which often occurs during these procedures.