The extent of lower extremity occlusive disease predicts short- and long-term patency following endovascular infrainguinal arterial intervention.
BACKGROUND
Endovascular revascularization of the femoral-politeal arterial segment has gained acceptance despite lower patency than surgical bypass due to lower morbidity. Choosing patients that are ideal candidates for endovascular therapy remains controversial. We have assessed hemodynamic factors that might predict longer primary patency after endovascular therapy.


METHODS
Ninety-nine limbs were treated with endovascular therapy from January 2001 to January 2005 with a mean and median follow-up of 338 and 293 days. Primary patency was considered lost when recurrent symptoms developed, ankle-brachial index (ABI) decreased following initial improvement, or a subsequent procedure was required. Kaplan-Meier analysis was used to evaluate patency.


RESULTS
Patients with an ABI > or =.5 prior to intervention had longer primary patency compared to those with an ABI less than .5 (P = .043). Having 1 or more patent tibial runoff vessels was associated with improved patency for the first 24 months post-procedure (P = .001).


CONCLUSIONS
Patients with an ABI > or =.5 or at least 1 patent tibial vessel runoff have significantly higher hemodynamic and clinical success following endovascular therapy of the femoral-popliteal arterial segment.
Hasanadka
Ravishankar
R
Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Brown
Kellie R
KR
Rilling
William S
WS
Rossi
Peter J
PJ
Hieb
Robert A
RA
Hohenwalter
Eric J
EJ
Seabrook
Gary R
GR
Lewis
Brian D
BD
Towne
Jonathan B
JB
D000368:Aged; D017130:Angioplasty / Q000379:methods; D055109:Ankle Brachial Index; D001157:Arterial Occlusive Diseases / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D016491:Peripheral Vascular Diseases / Q000473:pathology / Q000601:surgery*; D011150:Popliteal Artery / Q000601:surgery; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency