Guidelines for peripheral percutaneous transluminal angioplasty of the abdominal aorta and lower extremity vessels. A statement for health professionals from a special writing group of the Councils on Cardiovascular Radiology, Arteriosclerosis, Cardio-Thoracic and Vascular Surgery, Clinical Cardiology, and Epidemiology and Prevention, the American Heart Association.

Abstract

The diagnosis and management of peripheral vascu- lar disease has undergone tremendous change during the past two decades.Diagnostic angiography is com- plemented and, in some cases, even supplanted by digital subtraction techniques, duplex sonography, in- travascular ultrasound, and magnetic resonance imag- ing.Similarly, percutaneous transluminal angioplasty has evolved from a novelty to a vital component in the treatment of peripheral vascular disease.This docu- ment discusses the background and current state of peripheral angioplasty, including the prevalence of peripheral atherosclerosis and the history, clinical results, and risks of angioplasty.As a less invasive treatment, angioplasty has been placed in an awkward position between surgery and nonoperative therapy.To clarify the role of angioplasty, the determinants of success, requisite symptoms for intervention, indications for treatment, and appropriate clinical setting are described.Because the alternative treatment is typically surgery when a patient's condition necessitates intervention, the literature comparing the two treatments is reviewed.Epidemiology Prevalence and Incidence of Peripheral Arterial Disease The prevalence of peripheral arterial disease (PAD) in populations depends on the criteria used for diagnosis.Traditionally investigators have used the criterion of classic intermittent claudication, as determined by the "Guidelines for Peripheral Percutaneous Transluminal Angioplasty of the Abdominal Aorta and Lower Extremity Vessels" was approved by the American Heart Association Science Advisory