Determinants of procedural success and patency following subintimal angioplasty in patients with TASC C and D femoropopliteal arterial disease.
BACKGROUND
Subintimal percutaneous transluminal angioplasty (SIA) is a treatment option for long segment occlusions in the lower limb arteries. In the present study the factors influencing success and patency following SIA in patients with TransAtlantic Inter-Society Consensus (TASC) C and D peripheral arterial disease (PAD) were investigated.


RESULTS
The 63 consecutive SIAs were performed in 54 consecutive patients suffering from limb ischemia with TASC C and D lesions. Follow-up consisted of routine office visits with pulse examination, ankle-brachial index (ABI), and serial surveillance by color duplex ultrasound and scanning at 3- to 6-month intervals for 1 year. The morphology of lesions in all patients were type C (n=13, 20.6%) or type D (n=50, 79.4%). SIA was technically successful in 59 of 63 arterial occlusive lesions (93.6%). Post-procedural ABI was 0.89+/-0.16. The mean increase in ABI after SIA was 0.45 (range, 015-0.87). The primary patency rate at 12 months was 51.7%. Occlusion length, lesions involving the distal superficial femoral artery (SFA), and post-procedural distal run-off vessels (P=0.04, 0.006, 0.018, respectively) were independent patency determinants by multivariate analysis.


CONCLUSIONS
The length of the occlusion, lesions involving the distal SFA, and post-procedural distal run-off vessels were strong independent predictors for 1-year patency in TASC C/D severe occlusive femoropopliteal artery disease treated by SIA.
Kim
Seung Ju
SJ
The Cardiovascular Center of Gwangju Veterans Hospital, Gwangju, Republic of Korea.
Kim
Weon
W
Kim
Jong Bum
JB
Hong
Myung Ju
MJ
Kang
Won Yu
WY
Hwang
Sun Ho
SH
Kim
Wan
W
D000368:Aged; D017130:Angioplasty / Q000379:methods*; D005121:Extremities / Q000098:blood supply / Q000473:pathology; D005260:Female; D005263:Femoral Artery / Q000473:pathology*; D006801:Humans; D007511:Ischemia; D008297:Male; D015999:Multivariate Analysis; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000628:therapy*; D011150:Popliteal Artery / Q000473:pathology*; D011379:Prognosis; D014654:Vascular Patency