Annals of vascular surgery · 2019
Ipsilateral Antegrade Angioplasty for Flush Superficial Femoral Artery Occlusion versus Open Bypass Surgery.
Сравнительное исследованиеСтатьяМногоцентровое исследованиеРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Eleissawy Mohamed I, Elbarbary Ahmed H, Elwagih Mohammed M, Elheniedy Mohamed A, Santoso Charista, Fourneau Inge
Аннотация
BACKGROUND: Management of superficial femoral artery flush occlusion using the ipsilateral antegrade approach is challenging. The study aimed to assess technical feasibility, patency, and limb salvage of ipsilateral antegrade angioplasty versus surgery for this lesion in patients with lifestyle-limiting claudications and critical limb ischemia.
METHODS: Between June 2015 and March 2018, 53 patients were randomized to either ipsilateral antegrade angioplasty (n = 28) or surgical bypass (n = 25). We included patients with Trans-Atlantic Inter-Society Consensus IIB, C, or D lesions, having a patent popliteal artery. Technical success, patency, limb salvage, and major adverse events were assessed during the 12-month follow-up.
RESULTS: The technical success was 100% and 89.3% in the surgical and endovascular groups, respectively (P = 0.238). At 12 months, the primary, assisted, and secondary patency rates were 72% vs. 64.5%, 78.2% vs. 74.7%, and 81.6% vs. 74.2% in the surgical versus the endovascular groups, respectively, without significant differences between both groups. Limb salvage was 88% vs. 92% in the surgical versus the endovascular group, respectively (P = 0.564). The length of hospital stay was longer in the surgical versus the endovascular group (6.24 ± 0.37 vs. 1.84 ± 0.19 days, respectively, P = 0.001). Local complications were higher in the surgical group (P = 0.046).
CONCLUSIONS: Technical success, patency, and limb salvage of endovascular approach were comparable to surgical bypass. The endovascular approach had the advantages of reduced local complications and hospitalization.
METHODS: Between June 2015 and March 2018, 53 patients were randomized to either ipsilateral antegrade angioplasty (n = 28) or surgical bypass (n = 25). We included patients with Trans-Atlantic Inter-Society Consensus IIB, C, or D lesions, having a patent popliteal artery. Technical success, patency, limb salvage, and major adverse events were assessed during the 12-month follow-up.
RESULTS: The technical success was 100% and 89.3% in the surgical and endovascular groups, respectively (P = 0.238). At 12 months, the primary, assisted, and secondary patency rates were 72% vs. 64.5%, 78.2% vs. 74.7%, and 81.6% vs. 74.2% in the surgical versus the endovascular groups, respectively, without significant differences between both groups. Limb salvage was 88% vs. 92% in the surgical versus the endovascular group, respectively (P = 0.564). The length of hospital stay was longer in the surgical versus the endovascular group (6.24 ± 0.37 vs. 1.84 ± 0.19 days, respectively, P = 0.001). Local complications were higher in the surgical group (P = 0.046).
CONCLUSIONS: Technical success, patency, and limb salvage of endovascular approach were comparable to surgical bypass. The endovascular approach had the advantages of reduced local complications and hospitalization.
Предметные рубрики MeSH
AgedAged, 80 and overAngioplasty, BalloonBelgiumBlood Vessel ProsthesisBlood Vessel Prosthesis ImplantationConstriction, PathologicCritical IllnessEgyptFeasibility StudiesFemaleFemoral ArteryHumansIschemiaLength of StayLimb SalvageMaleMiddle AgedPeripheral Arterial DiseasePostoperative ComplicationsProspective StudiesRisk FactorsSaphenous VeinStentsTime FactorsTreatment OutcomeVascular Patency