Outcome predictors in selection of balloon angioplasty or surgery for peripheral arterial occlusive disease

Michael Dalsing, E. Cockerill, R. Deupree, G. Wolf, S. Wilson

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

In a selected group of men, surgical bypass and percutaneous balloon angioplasty (PTA) are equally effective therapy for ileo-femoropopliteal occlusive disease, provided immediate PTA failures are disregarded. Can we predict those patients likely to experience immediate PTA failure? Do any preintervention factors exist that favor PTA or surgical bypass for the remaining patients? Logistic regression analysis determined variables predictive of failure for the 19 immediate PTA failures and for the 17 patients with PTA and the 24 patients with surgical bypass who failed after initial intervention but before the end of 2 years. Two hundred sixty-three patients were enrolled. The analysis evaluated patient characteristics (age, weight, smoking status, diabetic status, and sickness impact profile score) as well as lesion site, percent lesion stenosis, runoff status, hemodynamic parameters, and indications. Two independent predictors of immediate PTA failure were diastolic hypertension (p = 0.032) and percent stenosis of study site (p = 0.035). The probability equation defined by the logistic regression analysis delineates patients at high risk for immediate PTA failure. Interestingly, no factor uniquely predicted delayed PTA or surgical failure. These data suggest that selected patients with diastolic hypertension and a severely stenotic or occluded artery are poor candidates for PTA. Either PTA or surgical bypass is effective therapy for the remaining patients.

Original languageEnglish
Pages (from-to)636-644
Number of pages9
JournalSurgery
Volume110
Issue number4
StatePublished - 1991

Fingerprint

Arterial Occlusive Diseases
Balloon Angioplasty
Peripheral Arterial Disease
Pathologic Constriction
Logistic Models
Sickness Impact Profile
Regression Analysis
Hypertension
Arteries
Hemodynamics
Smoking

ASJC Scopus subject areas

  • Surgery

Cite this

Outcome predictors in selection of balloon angioplasty or surgery for peripheral arterial occlusive disease. / Dalsing, Michael; Cockerill, E.; Deupree, R.; Wolf, G.; Wilson, S.

In: Surgery, Vol. 110, No. 4, 1991, p. 636-644.

Research output: Contribution to journalArticle

Dalsing, M, Cockerill, E, Deupree, R, Wolf, G & Wilson, S 1991, 'Outcome predictors in selection of balloon angioplasty or surgery for peripheral arterial occlusive disease', Surgery, vol. 110, no. 4, pp. 636-644.
Dalsing, Michael ; Cockerill, E. ; Deupree, R. ; Wolf, G. ; Wilson, S. / Outcome predictors in selection of balloon angioplasty or surgery for peripheral arterial occlusive disease. In: Surgery. 1991 ; Vol. 110, No. 4. pp. 636-644.
@article{7286e1def9b143d1b47688be507535ca,
title = "Outcome predictors in selection of balloon angioplasty or surgery for peripheral arterial occlusive disease",
abstract = "In a selected group of men, surgical bypass and percutaneous balloon angioplasty (PTA) are equally effective therapy for ileo-femoropopliteal occlusive disease, provided immediate PTA failures are disregarded. Can we predict those patients likely to experience immediate PTA failure? Do any preintervention factors exist that favor PTA or surgical bypass for the remaining patients? Logistic regression analysis determined variables predictive of failure for the 19 immediate PTA failures and for the 17 patients with PTA and the 24 patients with surgical bypass who failed after initial intervention but before the end of 2 years. Two hundred sixty-three patients were enrolled. The analysis evaluated patient characteristics (age, weight, smoking status, diabetic status, and sickness impact profile score) as well as lesion site, percent lesion stenosis, runoff status, hemodynamic parameters, and indications. Two independent predictors of immediate PTA failure were diastolic hypertension (p = 0.032) and percent stenosis of study site (p = 0.035). The probability equation defined by the logistic regression analysis delineates patients at high risk for immediate PTA failure. Interestingly, no factor uniquely predicted delayed PTA or surgical failure. These data suggest that selected patients with diastolic hypertension and a severely stenotic or occluded artery are poor candidates for PTA. Either PTA or surgical bypass is effective therapy for the remaining patients.",
author = "Michael Dalsing and E. Cockerill and R. Deupree and G. Wolf and S. Wilson",
year = "1991",
language = "English",
volume = "110",
pages = "636--644",
journal = "Surgery",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Outcome predictors in selection of balloon angioplasty or surgery for peripheral arterial occlusive disease

AU - Dalsing, Michael

AU - Cockerill, E.

AU - Deupree, R.

AU - Wolf, G.

AU - Wilson, S.

PY - 1991

Y1 - 1991

N2 - In a selected group of men, surgical bypass and percutaneous balloon angioplasty (PTA) are equally effective therapy for ileo-femoropopliteal occlusive disease, provided immediate PTA failures are disregarded. Can we predict those patients likely to experience immediate PTA failure? Do any preintervention factors exist that favor PTA or surgical bypass for the remaining patients? Logistic regression analysis determined variables predictive of failure for the 19 immediate PTA failures and for the 17 patients with PTA and the 24 patients with surgical bypass who failed after initial intervention but before the end of 2 years. Two hundred sixty-three patients were enrolled. The analysis evaluated patient characteristics (age, weight, smoking status, diabetic status, and sickness impact profile score) as well as lesion site, percent lesion stenosis, runoff status, hemodynamic parameters, and indications. Two independent predictors of immediate PTA failure were diastolic hypertension (p = 0.032) and percent stenosis of study site (p = 0.035). The probability equation defined by the logistic regression analysis delineates patients at high risk for immediate PTA failure. Interestingly, no factor uniquely predicted delayed PTA or surgical failure. These data suggest that selected patients with diastolic hypertension and a severely stenotic or occluded artery are poor candidates for PTA. Either PTA or surgical bypass is effective therapy for the remaining patients.

AB - In a selected group of men, surgical bypass and percutaneous balloon angioplasty (PTA) are equally effective therapy for ileo-femoropopliteal occlusive disease, provided immediate PTA failures are disregarded. Can we predict those patients likely to experience immediate PTA failure? Do any preintervention factors exist that favor PTA or surgical bypass for the remaining patients? Logistic regression analysis determined variables predictive of failure for the 19 immediate PTA failures and for the 17 patients with PTA and the 24 patients with surgical bypass who failed after initial intervention but before the end of 2 years. Two hundred sixty-three patients were enrolled. The analysis evaluated patient characteristics (age, weight, smoking status, diabetic status, and sickness impact profile score) as well as lesion site, percent lesion stenosis, runoff status, hemodynamic parameters, and indications. Two independent predictors of immediate PTA failure were diastolic hypertension (p = 0.032) and percent stenosis of study site (p = 0.035). The probability equation defined by the logistic regression analysis delineates patients at high risk for immediate PTA failure. Interestingly, no factor uniquely predicted delayed PTA or surgical failure. These data suggest that selected patients with diastolic hypertension and a severely stenotic or occluded artery are poor candidates for PTA. Either PTA or surgical bypass is effective therapy for the remaining patients.

UR - http://www.scopus.com/inward/record.url?scp=0026000316&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026000316&partnerID=8YFLogxK

M3 - Article

VL - 110

SP - 636

EP - 644

JO - Surgery

JF - Surgery

SN - 0039-6060

IS - 4

ER -