Subintimal angioplasty for advanced lower extremity ischemia due to TASC II C and D lesions of the superficial femoral artery.
OBJECTIVE
Subintimal angioplasty (SA) has evolved into a viable revascularization procedure for complex lower extremity lesions. Although patency rates are lower than those for autogenous bypass, limb salvage rates are comparable. This study reviewed the 8-year experience of SA in a single center.


METHODS
Records of patients undergoing SA were reviewed. Clinical presentation and noninvasive exams were used to classify patients. Lesions were categorized by TransAtlantic InterSociety Consensus (TASC) II guidelines. Outcomes included technical success, patency, amputation-free survival, and limb salvage.


RESULTS
120 patients with TASC II C/D lesions underwent SA. Technical success was 91%. Primary patency at 6 and 12 months was 90% and 73%. Secondary patency at 6 and 12 months was 94% and 85%. One-year amputation-free survival was 90%. One-year limb salvage was 98%.


CONCLUSIONS
SA for TASC C/D lesions is a safe procedure and may be considered an alternative to bypass, especially in high-risk patients.
Sidhu
Ramandeep
R
Jobst Vascular Center, Toledo, OH, USA.
Pigott
John
J
Pigott
Matthew
M
Comerota
Anthony
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D016009:Chi-Square Distribution; D003251:Constriction, Pathologic; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009820:Ohio; D018579:Patient Selection; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency