Percutaneous transluminal atherectomy: Preliminary results

Percutaneous transluminal atherectomy with the Simpson atherectomy catheter was performed in 10 patients with 14 severe atheromatous stenoses of the femoropopliteal arteries. Removal of plaque material with restoration of vessel patency was successful in all patients without complication. Further clinical follow-up will have to determine whether the recurrence rate of stenoses will be lower with this method than with conventional balloon angioplasty.     

Preliminary results of percutaneous transluminal atherectomy

Percutaneous transluminal atherectomy with the Simpson atherectomy catheter was performed in 5 patients with severe atheromatous stenoses of the femoropopliteal arteries. In all patients plaque material was removed with successful restoration of vessel patency. Further clinical follow-up will have to determine whether recurrence rate of stenosis will be lower with this method than with conventional balloon angioplasty.     

Percutaneous transluminal angioplasty of tibial arteries for limb salvage

Percutaneous transluminal balloon angioplasty (PTA) was performed in 17 tibial arteries with an average cross-sectional area stenosis of 92% (range 75–99%) in 13 patients (14 limbs) for limb salvage. In 4 of 14 lower extremities, PTA of femoropopliteal arteries was also performed. Technical success with 50% or less residual stenosis was achieved in all 17 tibial vessels. At approximately 2 months after PTA, clinical improvement had occurred in 10 of 14 limbs; no patient was made worse. Most recent follow-up (mean 19 months, range 8–34 months) revealed continued satisfactory clinical success with no further vascular intervention in 9 of these 10 limbs (one patient died). Short segmental stenoses, residual stenoses less than 40% following PTA, and absence of diabetes or gangrene appear to be predictors of favorable clinical outcomes. Our results suggest that PTA of focal tibial stenosis is an effective and safe treatment modality in properly selected patients and that wider use of PTA may be justified.     

Percutaneous transluminal angioplasty of peripheral bypass stenoses

Purpose: To assess the success of percutaneous transluminal angioplasty (PTA) in treating peripheral bypass stenoses. Methods: Patients who received a femoropopliteal or femorocrural bypass graft for limb ischemia were included in a duplex surveillance program. If duplex ultrasound revealed a short (<2 cm) severe (peak systolic velocity ratio ≥ 4.5) stenosis, patients were scheduled for arteriography and PTA. Fifty-eight peripheral bypass stenoses in 39 grafts in 37 patients were treated with PTA. The cumulative primary patency of treated stenoses was calculated. Results: During the first year after PTA 31 (53%) treated lesions remained patent, 15 (26%) lesions restenosed at a median interval of 5.0 (range 1–12) months and 4 (7%) bypasses occluded. The cumulative primary patency of 58 treated graft stenoses at 1 year was 60% [95% confidence interval (CI) 46%–74%] and 55% (95% CI 41%–70%) at 2 years. Graft body stenoses showed a better 2-year cumulative primary patency (86%; 95% CI 68%–100%) compared with juxta-anastomotic lesions (45%; 95% CI 29%–62%; p < 0.05). Conclusion: PTA is justifiable as the initial treatment of peripheral bypass stenoses. Nevertheless, the restenosis rate is rather high, especially in juxta-anastomotic lesions. Continuation of duplex surveillance after PTA and timely reintervention is recommended.     

PTA Versus Carbofilm-Coated Stents in Infrapopliteal Arteries: Pilot Study

Purpose: To determine the primary success and short-term patency of stent application as a primary treatment modality for high-grade lesions of the infrapopliteal arteries compared with treatment with percutaneous transluminal angioplasty (PTA) in critical limb ischemia in a randomized prospective study. Methods: Endovascular therapy was performed on 95 lesions in 51 patients (mean age 72.0 years, range 47–80 years) who presented clinically with Fontaine stages III and IV. One patient underwent treatment in both limbs. After angiographic lesion identification, patients were randomized for treatment by PTA (53 lesions in 27 patients) or stent application (42 lesions in 24 patients). Follow-up by clinical investigation and conventional angiography or spiral CT angiography was performed in 37 patients (57 lesions) 6 to 12 months after the procedure, or when clinically indicated. Evaluation was performed by two observers, double-blinded, with thresholds for lesion restenosis of 50% and 70%. Statistical evaluation was performed on a lesion basis by Kaplan–Meier estimated probability rates, and log-rank and Wilcoxon tests. The primary endpoint was the angiographic patency rate of treated lesions. Results: The inter-reader agreement was high (κ = 0.82). For the stent group the cumulative primary patency at 6 months was 83.7% at the 70% restenosis threshold, and 79.7% at the 50% restenosis threshold. For PTA, the primary patency at 6 months was 61.1% at the 70% restenosis threshold and 45.6% at the 50% restenosis threshold. Both results were statistically significant (p < 0.05). Conclusion: Infrapopliteal stent application is an effective treatment modality for high-grade lesions in chronic critical limb ischemia. Compared with PTA, higher patency rates can be expected after 6 months.     

Infrainguinal directional atherectomy: Long-term follow-up and comparison with percutaneous transluminal angioplasty

Purpose To assess the long-term results of directional atherectomy (DA) for femoropopliteal artery atherosclerotic lesions and to compare the results to those previously reported for percutaneous transluminal balloon angioplasty (PTA).Materials and Methods Eighty-four percutaneous DA procedures performed on 75 patients between July 1988 and August 1992 were retrospectively reviewed and evaluated for technical and initial clinical success. Long-term patency was assessed with a combination of ankle-brachial index measurements and angiography.Results Initial technical success was achieved in 77 of 84 procedures (92%). Follow-up of 72 patients was obtained, including 74 of the 84 (88%) DA procedures with a mean follow-up of 17.4 months (range 1–48 months). Primary patency was 78% at 1 year and 57% at 2 years. Patients with diabetes, complete luminal occlusion, or limb salvage situations had significantly lower patency.Conclusions Femoropopliteal artery DA can be performed safely with a high technical and initial clinical success. Long-term patency is improved when compared with published series for PTA. With this improvement in mind, DA may have a place in the treatment of focal infrainguinal stenoses.     

The predictive value of angiographic results for the outcome of percutaneous transluminal angioplasty in stenosed femoral bypass grafts

Purpose To assess the predictive value of immediate angiographic results after percutaneous transluminal angioplasty (PTA) for stenoses in femoral bypass grafts using duplex ultrasound (DUS) criteria. Methods A 1-year follow-up with DUS was performed in 38 patients with 50 stenoses in 41 grafts, treated with PTA for a graft stenosis. The indication for PTA according to DUS criteria was a severe stenosis in 43 lesions, and a moderate stenosis in 7 lesions. In the moderate stenosis group 3 patients showed claudication and 1 patient had a nonhealing ulcer. For the purposes of statistical evaluation, primary patency was considered present if the graft was not occluded. The graft was considered to have failed when it was found to be occluded on DUS, or when secondary interventions (surgery, repeat PTA) were performed. Results After 1 year the cumulative primary patency rate was 44$ [95% confidence interval (CI) 27.8–59.8]. Stenoses with initially good angiographic results after PTA (<30% residual stenosis) were 2.9 times more likely to be patent at 1 year than stenoses with initially poor or moderate angiographic results (hazard ratio 2.9, 95% CI 1.3–6.4,p=0.007). Conclusion A poor or moderate angiographic result immediately following PTA was prognostic for poor long-term results and may indicate a requirement for earlier surgical intervention.     

Percutaneous transluminal angioplasty of abdominal aortic stenoses

Percutaneous transluminal angioplasty (PTA) was performed on 25 patients with localized distal abdominal aortic stenoses. All patients were smokers and all complained of bilateral lower limb claudication. Eleven patients had small distal aortas and iliac vessels. Technically successful dilatation was achieved in all patients. Long-term follow-up was available on 17 of the patients. The mean follow-up period was 38 months. Cumulative patency at 5 years was 70%. Thirteen patients remain asymptomatic 15–83 months following PTA. Late failure occurred in 4 patients, 1–38 months following PTA. No complications related to PTA were experienced. PTA of localized aortic stenoses is a safe alternative to surgery and should be the treatment of choice in this condition.     

Cutting balloon percutaneous transluminal angioplasty for salvage of lower limb arterial bypass grafts: feasibility

PURPOSE: To evaluate the feasibility of cutting balloon percutaneous transluminal angioplasty (PTA) for treatment of neointimal hyperplasia in peripheral arterial bypass grafts. MATERIALS AND METHODS: Fifteen consecutive patients (six women, nine men; age range, 57-89 years; mean age, 71 years) were treated with cutting balloon PTA for 16 anastomotic stenoses after infrainguinal bypass (prosthetic grafts, seven patients; prosthetic-vein composite grafts, two; venous grafts, five; and ileofemoral stent-graft, one). Cutting balloon PTA was followed by conventional PTA to improve anastomotic diameter. Patients with stenotic vein grafts underwent cutting balloon PTA after failed conventional PTA; the other patients were treated primarily with cutting balloon PTA. Criteria for success were a lumen diameter improvement of greater than 50% or residual stenosis of 20% or less. Follow-up was performed with color duplex ultrasonographic surveillance. Patency rates and durations were calculated with Kaplan-Meier survival curves and log-rank statistics. RESULTS: Attempted conventional PTA (n = 6) prior to cutting balloon PTA was unsuccessful. Cutting balloon PTA was technically successful in 15 (94%) of 16 lesions, without clinical complications. Two local restenoses and one graft occlusion occurred between 5 and 7 months. The cumulative 6-month primary and secondary graft patency rates were 84% and 92%, respectively. At 12 and 18 months, they were 67% (95% CI: 0.34, 0.86) and 83% (95% CI: 0.48, 0.96), respectively; mean follow-up was 10.0 months. CONCLUSION: Cutting balloon PTA proved feasible for treatment of resistant peripheral arterial bypass graft stenosis, commonly caused by neointimal hyperplasia, with excellent technical success. Short-term patency with this technique appears to be superior to that with conventional PTA, and it compares well with patency of atherectomy for salvage of infrainguinal bypass grafts.     

Directional atherectomy treatment for hemodialysis access: early results.

The Simpson atherectomy device was used to treat 12 intragraft stenoses, six complete subclavian vein occlusions, and 14 venous outflow stenoses in 24 patients undergoing hemodialysis. Patients were followed up clinically and by means of venography at approximately 1, 3, 6, 9, and 12 months after treatment. Twenty-eight atherectomy specimens were examined histologically. Twenty-six (81%) of 32 lesions were treated with initial technical success. Including technical failures, seven (58%) of 12 intragraft stenoses are angiographically patent at a mean of 5.0 months and five (50%) of 10 are clinically patent at 6 months. Three (50%) of six subclavian veins are angiographically patent at a mean of 5.6 months, and four (67%) of six are clinically patent at 6 months. Three (21%) of 14 venous outflow stenoses are angiographically patent at a mean of 5.0 months and five (38%) of 13 are clinically patent at 6 months. Histologic examination showed neointimal fibromuscular hyperplasia in 26 of 28 lesions. When 30% or less angiographic residual stenosis is used as the criterion for initial technical success, directional atherectomy appears to be effective therapy for intragraft stenoses and, with balloon angioplasty, for some catheter insertion-related subclavian occlusions. Directional atherectomy appears to have a recurrence rate for venous outflow stenoses similar to that for balloon angioplasty when the same criterion is used.     

Femoropopliteal stent placement: long-term results.

Twenty-one patients who underwent percutaneous transluminal angioplasty (PTA) followed by attempted insertion of a self-expandable vascular endoprosthesis for femoropopliteal lesions were prospectively followed up for an average of 17.6 months with angiographic, Doppler ultrasound, and clinical examinations. Stents were placed bilaterally in one patient. Of the 22 lesions, 18 were total occlusions and four, stenoses. Stent placement was successful in 21 of 22 lesions. Nine occlusions occurred: four in the first 30 days and five 1-5 months after PTA. Three patients developed intrastent intimal hyperplasia that necessitated an additional percutaneous procedure. At 12 months, the patency rate without other interventions (the primary patency rate) was 49%. In patients who underwent secondary intervention (fibrinolysis, atherectomy, or PTA), the secondary patency rate was 67%, which fell to 56% after 18 months. At the end of the study, the overall rate of reocclusion was 43%. It is concluded that use of the self-expandable vascular endoprosthesis in the femoropopliteal region likely does not decrease the reocclusion rate after PTA alone. Its use is indicated for treatment of acute closures after femoropopliteal PTA.     

Percutaneous transluminal angioplasty of crural arteries.

In 91 patients suffering from peripheral arterial occlusive disease (Fontaine stage IIb-IV) 125 percutaneous transluminal angioplasties (PTA) of crural arteries were performed. Eighty-six of the dilatations were done in combination with a recanalization procedure (PTA, laser angioplasty, fibrinolysis) of a femoropopliteal obstruction in order to improve outflow. PTA was performed with 5 F balloon catheters 2.5 to 4 mm in diameter in combination with steerable guide wires. A primary technical success was achieved in 41 of 42 (97.6%) vessels with a single stenosis, in 64 of 68 (94.1%) vessels with 2 or more stenoses, and 9 of 15 (60%) vessels with total occlusions (overall primary success rate 91.2%). Complications included spasm (n = 3), thrombosis (n = 2), peripheral embolization (n = 2), and dissection (n = 1). None of the complications required surgical intervention. After PTA, accumulative patency rate of 71% at 2 years and 64.2% at 3 years was achieved. These results demonstrated that PTA of crural arteries is a safe procedure with an excellent primary success rate and satisfying long-term results. Thus we believe that even arterial occlusive disease in the clinical stage Fontaine IIb should be accepted as an indication for crural PTA. Furthermore, crural PTA should be used to improve reduced peripheral outflow after femoropopliteal PTA.     

长球囊治疗重症下肢动脉缺血性病变的近期疗效观察

目的观察长球囊治疗重症下肢动脉缺血性病变的可行性和近期效果。方法对2007年1至6月收治的21例重症下肢缺血患者,根据病变范围,选择合适长度的球囊对狭窄或闭塞性病变进行球囊扩张成形,相临近多处短段病变也尽可能采用长球囊一次成形;观察术中及术后患者的并发症发生率、技术成功率和临床疗效;通过随访,判断治疗的初始通畅率、再次通畅率、救肢率和生存率。结果21例患者早期技术性的并发症2例(9.5%),均为穿刺点假性动脉瘤。狭窄性病变的技术成功率100%;股、腘动脉闭塞性病变再通的总的成功率为88.9%,其中采用内膜下成形(5例)技术成功4例;胫前动脉、胫后动脉和腓动脉闭塞性病变的技术成功率分别为55.6%、28.6%和25.0%。未出现影响血流的夹层。临床成功率为90.5%。术后平均住院时间6 d。术后6个月的初始通畅率为95.2%;再次通畅率和救肢率均为100%。结论对于重症下肢动脉缺血性病变患者,长球囊PTA后无影响血流的夹层瘤出现,初始技术和临床成功率都很高,是安全、有效的治疗重症下肢动脉缺血性病变的方法。     

Recanalization of Acute and Subacute Femoropopliteal Artery Occlusions with the Rotarex Catheter: One Year Follow-up, Single Center Experience

Purpose: To assess the efficacy and safety of a new rotational catheter for percutaneous removal of fresh and organized thrombi in the femoropopliteal artery. Methods: Forty-one limbs in 38 patients (age 56–90 years, mean 75.6 years) with acute, subacute or chronic femoropopliteal occlusions of 1–180 days’ duration (mean 31.6 days) were treated with the Rotarex device. The Fontaine stage was mainly IIB (Rutherford 2–3, 22 patients) or III (Rutherford 4, 14 patients). The length of occlusion varied from 2 to 35 cm (mean 13.1 cm). After recanalization percutaneous transluminal angioplasty (PTA) was performed if there was a residual stenosis of >25%. Patients were followed up with color Doppler ultrasound at 48 hr and clinically with Doppler pressures and oscillometry at 3, 6, and 12 months. Results: After an average of two passages with the Rotarex catheter all but two limbs required PTA for residual stenosis >25%. Five patients needed additional stenting. Major complications were one groin hematoma requiring blood transfusion and one arteriovenous fistula spontaneously thrombosing after unsuccessful primary prolonged balloon dilation. Distal embolizations occurred in 10 patients; 6 clinically relevant emboli were aspirated. All occlusions were technically successfully recanalised there were 2 early reocclusions after 1 day and two at 2 weeks. Brachial–ankle indices improved from an average of 0.41 before to 0.93 after recanalization. Primary and secondary patency rates were 62% / 84% after 6 months and 39% / 68% after 1 year. The amputation-free survival at 12 months was 100%. Conclusion: The Rotarex mechanical thrombectomy device is an efficient, quick, easy to handle, and safe tool for the treatment of acute, subacute or even chronic peripheral arterial thromboembolic occlusions. It can be used for short or long occlusions with equal success, provided the obstruction is not heavily calcified and has been safely passed with a guidewire first.     

Comparison of cutting balloon versus high-pressure balloon angioplasty for resistant venous stenoses of native hemodialysis fistulas

PURPOSE: To compare the technical success, safety, and patency of cutting balloon angioplasty versus high-pressure balloon angioplasty in the treatment of resistant native hemodialysis fistula stenoses. MATERIALS AND METHODS: The authors retrospectively reviewed 1,220 percutaneous transluminal angioplasty procedures performed to treat dysfunctional native hemodialysis fistulas. Seventy patients with stenoses resistant to conventional balloon angioplasty (up to 24 atm) were included in this study: 35 patients underwent cutting balloon angioplasty from September 2003 through February 2005, and 35 patients underwent high-pressure balloon angioplasty from March 2005 through April 2006. Evaluation included technical success, complications, and postintervention patency rates up to 6 months. RESULTS: The technical success rates were similar between the cutting balloon (100%) and high-pressure balloon (97.1%) groups. After cutting balloon angioplasty, the primary lesion patency rates were 100% (35/35), 88.6% (31/35), and 71.4% (25/35) at 1 month, 3 months, and 6 months, respectively. After high-pressure balloon angioplasty, the primary lesion patency rates were 97.1% (34/35), 62.9% (22/35), and 42.9% (15/35) respectively. The primary lesion patency rates at 3 and 6 months were significantly better with cutting balloon angioplasty than with high-pressure balloon angioplasty (P = .018 and .009, respectively). There were no device-related complications in the cutting balloon group. Six device-related extravasations occurred in the high-pressure balloon group. CONCLUSIONS: The results of this retrospective study suggest that, for resistant stenoses in native hemodialysis fistulas, both high-pressure balloon and cutting balloon angioplasty are effective; however, cutting balloon angioplasty seems to provide more long-standing primary patency at 6-month follow-up.     

Insufficient hemodialysis access fistulas: late results of treatment with percutaneous balloon angioplasty

Forty-six patients with malfunctioning hemodialysis access fistulas were treated with balloon angioplasty. The initial percutaneous transluminal angioplasty procedure was successful in 16 (89%) of 18 patients with stenoses and in 13 (46%) of 28 with occlusions. In ten patients (seven with stenoses and three with occlusions) repeated dilation (two to five times; mean, two times) became necessary due to recurrent malfunction 1-24 months (mean, 6 months) after the first intervention. In the 16 patients with stenoses, the patency rate after 6 months was 93%; after 1 year, 91%; and after 2 years, 57%. In the 12 patients with occlusions, the rates were 80%, 50%, and 14%, respectively. Dilation of stenoses in malfunctioning hemodialysis fistulas is the procedure of choice. If hemodialysis shunts malfunction, immediate dilation of stenotic lesions should be performed to prevent occlusion.     

Early experience and midterm follow-up results with a new,rotational thrombectomy catheter

Purpose: To assess the efficacy and safety of the Rotarex rotational thrombectomy catheter in treating occlusions of the femoropopliteal arteries. Methods: The Rotarex catheter (Straub Medical, Switzerland) is a rotational thrombectomy device which is supposed to be able to remove fresh and partially organized clot material from an acutely or subacutely occluded vessel. Nineteen limbs of 18 patients (10 women, 8 men; mean age 72.9 ± 7.3 years) with acute or subacute (23 ± 16 days) occlusions of the middle or distal third of the superficial femoral artery or the popliteal artery were treated. The occlusions were 3–20 cm long. Results: Thrombectomy was technically successful in 15 of 19 vessels (79%). The primary procedural success including additional procedures such as angioplasty and/or stent-graft placement in 17 limbs was 94%. The mean ankle-brachial index improved from 0.36 ± 0.26 (before thrombectomy) to 0.81 ± 0.21 (2 days after the procedure) (p = 0.012). Clinical symptoms shifted to at least one Fontaine stage lower in 13 limbs. As complications we observed two perforations (arteries showing heavily calcified plaques), one arteriovenous fistula and three distal embolizations. One perforation, the fistula and one intimal tear after percutaneous transluminal angioplasty were treated with covered stents; the three distal embolizations were treated successfully with aspiration or Rotarex thrombectomy. In the other perforation the intervention was terminated. None of the complications needed surgical treatment. The complication rate was 31.5%. Follow-up studies showed three early (4–11 days) and six late (1–6 months) reocclusions. The cumulative primary patency rate was 68 ± 12% at 3 months, and 39 ± 13% at 6, 12 and 19 months; the secondary patency rate was 68 ± 12% at 3 months and 53 ± 13% at 6, 12 and 20 months. Conclusion: The Rotarex thrombectomy catheter is effective and quick in treating acute and subacute occlusions of the superficial femoral and popliteal arteries. It should not be used in arteries with heavily calcified plaques because of the risk of perforation. Limited long-term patency is mainly due to the complexity of the underlying lesion. Our results suggest that the Rotarex mechanical thrombectomy catheter is effective and might serve as an alternative treatment modality to intra-arterial lysis.     

Percutaneous transluminal cutting-balloon angioplasty for hemodialysis access stenoses resistant to conventional balloon angioplasty

Purpose: To examine the value of cutting-balloon percutaneous transluminal angioplasty (PTA) for hemodialysis access with residual stenosis after conventional balloon PTA.

Material and Methods: Angioplasty with conventional balloons was performed on 48 hemodialysis access stenoses in 28 patients. If the balloon waist still remained at the rated burst pressure, the balloon was reinflated up to three times. Fifteen of 48 stenoses had residual stenoses of more than 30% after conventional balloon PTA. In these 15 stenoses, additional cutting-balloon PTA was performed.

Results: The mean residual percent diameter stenoses before and after conventional balloon PTA were 77.6±3.4% and 48.6±8.5%, respectively. Additional cutting-balloon PTA decreased the mean residual percent diameter to 27.9±10.0%, and the cutting balloon was completely inflated without complication. In 12 patients, the 6-month primary patency rate (±SE) was 90.0% (9.5), and the 1-year primary patency rate (±SE) was 25.0% (14.8).

Conclusion: Additional cutting-balloon PTA was found useful for reducing residual stenosis.     

Cutting balloon angioplasty for primary treatment of hemodialysis fistula venous stenoses: preliminary results

PURPOSE: To assess the efficacy of the cutting balloon as the primary tool in percutaneous transluminal angioplasty of hemodialysis access stenoses. MATERIALS AND METHODS: A prospective study of symptomatic patients with stenoses of 50% or more in their hemodialysis accesses was undertaken. Provided that no contraindication to the use of cutting balloons existed, the stenoses were treated with the cutting balloon with use of a maximum of a 1:1.1 ratio between expected vessel diameter and balloon diameter. In cases in which dilation to the full diameter of the cutting balloon left a greater than 30% residual stenosis, postprocedural dilation with conventional balloons was carried out. Patient access function was followed. Twenty-nine patients with 42 stenoses have now reached 6 months of follow-up after cutting balloon angioplasty. RESULTS: Technical and clinical success rates were 100%. Slight local extravasation occurred in three cases: two had continued pain after the balloon was deflated and were therefore treated with balloon compression with resolution of symptoms and angiographic findings. In two cases, elastic recoil required stent placement to correct the stenosis. At 6 months, 22 patients (76%) remain in the primary patency category. Inclusion of those with primary assisted patency yields 26 patients (90%), and an additional patient had secondary patency, for a total of 93%. Two patients died of causes not directly related to dialysis. CONCLUSION: The high degree of technical and clinical success likely reflects the lack of major complications. The 6-month follow-up results match those of other series. Further follow-up will show whether this technique produces better results over the long term.     

Percutaneous transluminal angioplasty in nonspecific aortoarteritis (Takayasu's disease): Experience of 16 cases

Sixteen patients with aortoarteritis underwent percutaneous transluminal angioplasty for dilatation of 19 stenotic arteries. Sites included renal arteries (9), subclavian arteries (5), innominate artery (1), abdominal aorta (2), and descending thoracic aorta (2). Angiographic success was obtained in 14 lesions (74%) and partial success in 1 stenosis. The procedure was unsuccessful in 3 renal and 1 subclavian stenoses (21%). There were three complications. Clinically, there was cure of hypertension in three patients and improvement in six patients who had hypertension. Relief of claudication or return of pulsations was observed in seven patients. There was no evidence of any recurrence in the follow-up period (2–33 months). We conclude that percutaneous transluminal angioplasty is a safe and effective procedure for treating symptomatic stenotic lesions in aortoarteritis.