Popliteal-to-distal (PD) bypass versus infragenicular percutaneous transfemoral angioplasty (PTA) to treat limb threatening ischemia

Abstract

Objectives:The purpose of this study is to compare the results of revascularization in a critically ischaemic limb due to infragenicular arterial diseases, using either the conventional bypass operations or endovascular revascularization.Methods: Over a period from December 2010 and May 2012, forty patients suffering from limb-threatening ischaemia were included in this study; all of the patients had peripheral arterial disease falling into Fontaine III & IV categories. All patients had extensive infrapopliteal disease (TASC type C&D). All patients had a good run off at the posterior tibial, anterior tibial or dorsalis pedis. The patients were divided into group A treated by PD bypass surgery and group B treated by endovascular management.Results: The primary patency rate of group A at 6 months and one year was 77% and 65% respectively, with limb salvage rate 80% after one year follow up. In group B the primary patency rate at 6 months and one year was 65% and 60% respectively, with limb salvage rate 75% after one year follow up.Conclusions: PD bypass has primary success rate and limb salvage rates higher than infragenicular PTA that might be due to our still growing experience in PTA.