Balloon catheter dilation for limb salvage.

Balloon catheter dilation was attempted as the initial treatment for limb salvage in 83 patients, of whom 38 had rest pain only, 32 had ischemic ulcers, and 13 had gangrene. One month 87 (78%) of these dilations showed an increase in flow, 14 (13%) had no change, and ten (9%) had thrombosis at the site of dilation. After six months, 23 of 49 dilations showed evidence of restenosis, though 27 maintained flow greater than predilation levels. Only six of 19 lesions in 14 patients who had no surgery maintained improved flow after one year. Overall limb salvage for patients with successful dilation was 71% (51 of 72 patients), and the rate of limb salvage after dilation alone was 34%. Transluminal dilation appears to be a useful method of treatment for patients with limb-threatening ischemia and should be considered complementary to other methods. The tendency for recurrence of stenosis mandates careful, frequent follow-up.