title: Subintimal angioplasty for advanced lower extremity ischemia due to TASC II C and D lesions of the superficial femoral artery.
abstract: 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.
authors.affiliation: Jobst Vascular Center, Toledo, OH, USA.
authors.forename: Ramandeep
authors.initials: R
authors.lastname: Sidhu
authors.forename: John
authors.initials: J
authors.lastname: Pigott
authors.forename: Matthew
authors.initials: M
authors.lastname: Pigott
authors.forename: Anthony
authors.initials: A
authors.lastname: Comerota
mesh_terms: 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