Adjunctive use of the balloon dilatation catheter during vascular reconstructive procedures

Abstract

Intraoperative balloon angioplasty was performed on 80 patients undergoing a concomitant vascular reconstructive procedure during the past 30 months. All angioplasties were performed by the operating surgeon with the aid of fluoroscopy and in conjunction with the vascular reconstruction. The primary purpose of balloon angioplasty was to either increase inflow (66%) or outflow (23%) in association with a planned vascular procedure. The remaining patients had a variety of other arterial dilatations. Dilatation obviated the need for additional arterial reconstructions in these elderly patients. One episode of peripheral embolization constituted the only operative complication. Follow-up ranged from 1 to 30 months (mean, 13.4 months). Sixty-four patients remained asymptomatic during the follow-up period. Sixteen patients became symptomatic in the postoperative period and underwent angiography. One iliac and three superficial femoral arteries had restenosed. The remaining 12 patients had additional vascular problems not associated with the dilatation or previous operation. The intraoperative use of the balloon catheter by the vascular surgeon broadens the therapeutic armamentarium available for the correction of multiple, symptomatic, arterial lesions. Balloon angioplasty as a separate procedure was thus avoided, resulting in decreased morbidity and expense. The scope of arterial reconstructions was expanded without expansion of the operation. The balloon catheter should be used intraoperatively as adjunctive therapy in appropriate circumstances.