Comparison of Endovascular Versus Bypass Surgery in Femoropopliteal TASC II D Lesions: A Single-Center Study

Veraldi, Gian Franco; Mezzetto, Luca; Macrì, Marco; Criscenti, Paolo; Corvasce, Arianna; Poli, Ranieri

doi:10.1016/j.avsg.2017.09.008

Cited by 23 publications

(20 citation statements)

References 31 publications

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“…Guo (Guo et al 2015 ) reported a technical success rate of 95 % and a secondary patency rate of 63 % at 3 years after endovascular treatment of TASC II D femoropopliteal lesions. Dias-Neto and others (Dias-Neto et al 2018 ; Joo et al 2017 ; Veraldi et al 2018 ) reported similar mean procedure duration and fluoroscopy time.…”

Section: Discussionmentioning

confidence: 73%

Endovascular recanalization of chronic total occlusions of the native superficial femoral artery after failed femoropopliteal bypass in patients with critical limb ischemia

Minici

Ammendola

Talarico³

et al. 2021

CVIR Endovasc

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Background Femoropopliteal bypass occlusions are a significant issue in patients with critical limb ischemia and chronic total occlusion of the native superficial femoral artery, which challenges vascular surgeons and interventional radiologists. Performing a secondary femoropopliteal bypass is still considered the standard of care, although it is associated with a higher complication rate and lower patency rate in comparison with primary bypass. Over the past few years, angioplasty has been commonly used, with the development in endovascular technologies, to treat chronic total occlusions of the native superficial femoral artery, with a good technical success rate and clinical prognosis. The purpose of the study is to assess the outcome of endovascular recanalization of chronic total occlusions of the native superficial femoral artery, in patients unfit for surgery with critical limb ischemia after failed femoropopliteal bypass. Results A total of 54 patients were treated. 77.8 % of the conduits were PTFE grafts; the remainder were single-segment great saphenous veins. The most common clinical presentation was rest pain. Technical success was achieved in 51 (94.4 %) of 54 limbs. Angiographically, 77.8 % of the lesions were TASC II category D, while 22.2 % were TASC II category C. The average length of the native SFA lesions was 26.8 cm. Clinical success, with improved Rutherford classification staging, followed each case of technical success. The median follow-up value was 5.75 years (IQR, 1.5–7). By Kaplan-Meier survival analysis, primary patency rates were 61 % (± 0.07 SE) at 1 year and 46 % (± 0.07 SE) at 5 years. Secondary patency rates were 93 % (± 0.04 SE) at 1 year and 61 % (± 0.07 SE) at 5 years. Limb salvage rates were 94 % (± 0.03 SE) at 1 year and 88 % (± 0.05 SE) at 5 years. Conclusions The endovascular recanalization of chronic total occlusions (CTO) of the native superficial femoral artery (SFA) after a failed femoropopliteal bypass is a safe and effective therapeutic option in patients unfit for surgery with critical limb ischemia.

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Section: Discussionmentioning

confidence: 73%

Endovascular recanalization of chronic total occlusions of the native superficial femoral artery after failed femoropopliteal bypass in patients with critical limb ischemia

Minici

Ammendola

Talarico³

et al. 2021

CVIR Endovasc

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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: 86%

“…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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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…9–12 DCBs are desirable for short and less stenotic lesions, especially in older and more fragile patients. 13 The DCB combines conventional balloon angioplasty with a drug delivery system that enables the drug to pass to the vessel wall and inhibit neointimal plaque formation. Paclitaxel-coated balloons transfer paclitaxel to the vessel wall uniformly, which decreases intimal hyperplasia and affects atherosclerosis mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Comparison of paclitaxel-coated balloon angioplasty with femoropopliteal bypass surgery in treating femoropopliteal lesions

2020

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Objective To compare drug (paclitaxel)-coated balloon angioplasty with femoropopliteal bypass surgery in the treatment of femoropopliteal lesions. Methods A retrospective study was performed between January 2015 and January 2019, covering a four-year period. All subjects who underwent femoropopliteal bypass surgery and drug-coated balloon angioplasty over a four-year period were evaluated. The subjects’ demographic characteristics, lesion characteristics, treatment outcomes and disease-free survival were collected. Subjects were divided into the femoropopliteal bypass group (Group A) and the drug-coated balloon angioplasty (Group B) group. Results In total, 220 subjects were enrolled. Both Group A and Group B consisted of 110 subjects. The proportion of patients with a claudication distance between 0 and 50 m was significantly higher in Group A, and the proportion of patients with a claudication distance between 50 and 100 m was significantly higher in Group B ( p = 0.001). In terms of the Rutherford levels, moderate claudication was significantly higher in Group B, and severe claudication was significantly higher in Group A ( p = 0.001). The lesion length for the subjects in Group A was significantly longer than that in Group B (24.61 ± 2.79 mm for Group A and 18.59 ± 3.95 mm for Group B, p = 0.001). The stenosis degree in Group A was also significantly higher than that in Group B (96.82 ± 4.32% for Group A and 94.85 ± 4.55% for Group B, p = 0.001). The duration of the procedure, duration of hospitalization and rate of bleeding in Group A were significantly higher than those in Group B. The incidence of overall morbidity and reintervention rates in Group B were significantly higher than that in Group A. The preoperative ankle brachial index values of the subjects in Group B were statistically significantly higher than those in Group A (0.56 ± 0.08 for Group A and 0.61 ± 0.08 for Group B, p = 0.001). The change in the ankle brachial index measurement of the subjects in Group A with respect to the preprocedure value was significantly greater than that in Group B ( p = 0.001). For primary patency, there was a significant difference between the groups in the distribution of the duplex ultrasound results at the 3rd, 6th, 9th and 12th month control points ( p = 0.001). At all control points, Group A had better primary patency rates, whereas the secondary patency rates did not differ. In total, among the 220 patients, 125 (56.8%) were disease free, and 95 (43.2%) experienced recurrence. The mean disease-free survival times for Group A and Group B were 10.45 ± 0.28 months and 9.11 ± 0.37 months, respectively. The disease-free survival rates were significantly higher in Group A ( p = 0.001, p < 0.05). Conclusion Femoropopliteal bypass resulted in better disease-free survival rates than drug-coated balloon angioplasty and serves as an effective modality for the treatment of femoropopliteal lesions.

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Comparison of Endovascular Versus Bypass Surgery in Femoropopliteal TASC II D Lesions: A Single-Center Study

Cited by 23 publications

References 31 publications

Endovascular recanalization of chronic total occlusions of the native superficial femoral artery after failed femoropopliteal bypass in patients with critical limb ischemia

Endovascular recanalization of chronic total occlusions of the native superficial femoral artery after failed femoropopliteal bypass in patients with critical limb ischemia

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

Comparison of paclitaxel-coated balloon angioplasty with femoropopliteal bypass surgery in treating femoropopliteal lesions

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