Outcomes of Bypass Surgery Versus Endovascular Therapy for TASC II C and D Femoro-Popliteal Lesions in Patients with Chronic Limb Ischemia.
- Author:
Sung Hwan SHIN
1
;
Se Hwan KWON
;
Jin Hyun CHO
;
Hyung Joon AHN
;
Joo Hyung OH
;
Ho Chul PARK
Author Information
1. Department of Surgery, Kyung Hee University School of Medicine, Seoul, Korea. whipple@hanafos.com
- Publication Type:Original Article
- Keywords:
Peripheral arterial occlusive disease;
Femoro-popliteal lesion;
Endovascular therapy;
Bypass surgery
- MeSH:
Angioplasty, Balloon;
Consensus;
Extremities;
Follow-Up Studies;
Humans;
Ischemia;
Limb Salvage;
Medical Records;
Stents
- From:Journal of the Korean Society for Vascular Surgery
2010;26(2):90-97
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We wanted to define the appropriate treatment modalities for Trans-Atlantic Inter-Society Consensus (TASC) II C and D femoro-popliteal lesions. So we compared the primary patency rate and several clinical factors between percutaneous balloon angioplasty with or without stenting (PTA/S) and bypass surgery (BP). METHODS: We reviewed the medical records of patients who underwent BP or PTA/S for TASC II C (BP-C, PTA/S-C) and D (BP-D, PTA/S-D) femoro-popliteal lesions from March 2001 to May 2009. We analyzed the primary and secondary patency rates, and the major limb salvage rates. RESULTS: Eighty two limbs in 74 patients (mean age: 68.7+/-10.2 years, males: 82.9%) were treated (PTA/S-C: 18, PTA/S-D 19: BP-C 12, BP-D 33). The mean follow-up duration was 30.0+/-19.0 months. The twenty four month primary patency rates was 82.4% for PTA/S-C and 73.3% for BP-C (P=0.876), and 45.3% for PTA/S-D and 66.6% for BP-D (P=0.034). The twenty four month secondary patency rates were 88.2% for PTA/S-C and 73.3% for BP-C (P=0.669), and 54.7% for PTA/S-D and 73.3% for BP-D (P=0.077). The twenty four month major limb salvage rates were 100.0% for PTA/S-C and 75.0% for BP-C (P=0.030) but there were no statistical differences between the TASC II D groups (P=0.377). CONCLUSION: Bypass surgery is a preferred initial therapeutic option for TASC II D femoro-popliteal lesions. However, several clinical factors must be carefully considered when selecting the primary treatment modality for TASC II C lesions.
