Improvement in claudication after angioplasty of distal ostial collateral stenosis in patients with long-segment occlusion of the femoral artery

Purpose: To evaluate the angiographic and clinical effects of percutaneous transluminal angioplasty (PTA) of distal ostial collateral stenoses in patients with claudication and long-segment occlusion of the superficial femoral artery (SFA). Methods: In ten patients (9 men, 1 woman) with stable intermittent claudication due to chronic long-segment occlusion of the SFA a high-grade stenosis of the distal collateral ostium of the deep femoral artery to the popliteal artery were dilated. PTA was performed using popliteal artery access. Claudication distances on the treadmill and ankle-brachial pressure indices (ABI) at rest were analyzed before, 1 week, and 14 weeks after PTA. Results. Initial technical success was obtained in all patients. There were no significant periprocedural local complications. The initial mean claudication distance on the treadmill increased significantly from 107 +/- 65 m to 306 +/- 209 m (p < 0.01), the maximal claudication distance from 203 +/- 128 m to 392 +/- 167 m (p < 0.01). The mean ABI changed slightly but significantly (0.61 +/- 0.08 vs. 0.64 +/- 0.07; p < 0.05). Early follow-up after 14 weeks revealed no clinical deterioration. Conclusion: This new technique is considered helpful in patients with well-defined claudication acid long-segment occlusion of the SFA.