Comparison of Clinical Outcomes between Endovascular Therapy with Self-Expandable Nitinol Stent and Femoral–Popliteal Bypass for Trans-Atlantic Inter-Society Consensus II C and D Femoropopliteal Lesions

Okuno, Shota; Iida, Osamu; Iida, Takahito; Takahara, Mitsuyoshi; Yamaoka, Terutoshi; Kitano, Ikuro; Asai, Mitsutoshi; Masuda, Masaharu; Okamoto, Shin; Ishihara, Takayuki; Nanto, Kiyonori; Kanda, Takashi; Tsujimura, Takuya; Matsuda, Yasuhiro; Mano, Toshiaki

doi:10.1016/j.avsg.2018.09.024

Cited by 9 publications

(5 citation statements)

References 18 publications

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“…The 2-year results of the present study showed similar patency rates and freedom from TLR for the stent and bypass groups. 17 This was in contrast to most retrospective data 24–26 but in accordance with other 1-year RCT results. 7,8 The final analysis of the 4-year results of our study shows that the long-term outcomes of NS are significantly different to VBP in several aspects.…”

Section: Discussionsupporting

confidence: 89%

Vein Bypass Versus Nitinol Stent in Long Femoropopliteal Lesions

et al. 2022

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Objectives: The aim of this study was to compare technical success, patency rates and clinical outcomes of vein bypass (VBP) with angioplasty and nitinol stents (NS) in femoropopliteal Trans-Atlantic Intersociety Consensus (TASC) II C and D lesions. Summary Background Data: Guidelines widely recommend an endovascular-first strategy for long femoropopliteal lesions without sufficient data comparing it with vein bypass surgery. Methods: A single-center prospective, randomized controlled trial (RCT) was performed, after approval of the local ethics committee, with technical success, primary and secondary patency as primary endpoints. Secondary endpoints were limb salvage, survival, complications, and clinical improvement. Results: Between 2016 and 2020, 218 limbs (109 per group) in 209 patients were included. Baseline and lesion characteristics were similar in both groups with a mean lesion length of 268 mm. The indication for treatment was chronic limb threatening ischemia in 53% of limbs in both groups. Technical success was feasible in 88% in the stent group. During a 4-year follow-up, primary patency, freedom from target lesion revascularizations, limb salvage, survival and complications showed no significant differences between the groups. At 48 months secondary patency for the bypass group was 73% versus 50% in the stent group (P = 0.021). Clinical improvement was significantly superior in the bypass group with 52% versus 19% reaching a Rutherford 0 category (P < 0.001). Conclusions: This is the largest RCT comparing angioplasty with NS and vein bypass in femoropopliteal TASC II C and D lesions and the first to report 4-year results. The data underline the feasibility of endovascular treatment in long lesions but also emphasize the advantages of VBP.

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Section: Discussionsupporting

confidence: 89%

Vein Bypass Versus Nitinol Stent in Long Femoropopliteal Lesions

et al. 2022

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“…Previous studies comparing OSB with PTA/S reported that bypass surgery resulted in a three year patency rate of 74% vs. 60% for endovascular treatment, and a five year patency 69.4% vs. 45.2%, respectively. 23,24 A meta-analysis comparing OSB and PTA/S for the treatment of femoropopliteal arterial disease showed that an endovascular first approach may be advisable in patients with significant comorbidity, whereas for fit patients with probable longer term survival, a bypass procedure should be offered as first line interventional treatment. 25 The randomised BASIL trial and findings from Darling et al raise the possibility that patients may benefit from a bypass first strategy as opposed to an angioplasty first strategy.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Long Term Outcomes After Endovascular Treatment Versus Bypass Surgery in Chronic Limb Threatening Ischaemia Patients with Long Femoropopliteal Lesions

Zlatanović¹,

Mahmoud

Činara³

et al. 2021

European Journal of Vascular and Endovascular Surgery

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“…Compared to our result, in most retrospective studies for the treatment of long femoropopliteal lesions, bypass procedures had remarkably higher primary (75 -80%) and secondary patency rates (85 -94%) at 2 years. However, in the majority of trials the percentage of claudicants was higher and the mean lesion lengths were shorter, except for the results of Veraldi et al with 79% CLTI patients [7][8][9][10] .…”

Section: Discussionmentioning

confidence: 87%

“…For longer lesions bypass surgery is recommended, but this is not based on a high level of evidence and was challenged by several trials. Three recent randomized controlled trials (RCT) showed noninferiority of endovascular therapy for long femoropopliteal lesions (TASC II type C and D) compared to bypass surgery regarding primary patency and freedom from target lesion revascularization (TLR) [4][5][6] , which is in contrast to the majority of retrospective studies [7][8][9][10] . The revascularization techniques in the three RCTs varied considerably.…”

Section: Main Text Introductionmentioning

confidence: 99%

Comparison of Prosthetic and Vein Bypass with Nitinol Stents in Long Femoropopliteal Lesions

Kluckner

Gratl

Wipper

et al. 2022

Annals of Vascular Surgery

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Comparison of Clinical Outcomes between Endovascular Therapy with Self-Expandable Nitinol Stent and Femoral–Popliteal Bypass for Trans-Atlantic Inter-Society Consensus II C and D Femoropopliteal Lesions

Cited by 9 publications

References 18 publications

Vein Bypass Versus Nitinol Stent in Long Femoropopliteal Lesions

Vein Bypass Versus Nitinol Stent in Long Femoropopliteal Lesions

Comparison of Long Term Outcomes After Endovascular Treatment Versus Bypass Surgery in Chronic Limb Threatening Ischaemia Patients with Long Femoropopliteal Lesions

Comparison of Prosthetic and Vein Bypass with Nitinol Stents in Long Femoropopliteal Lesions

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