title: Outcome analysis of infrapopliteal percutaneous transluminal angioplasty and bypass graft surgery with nonreversed saphenous vein for individuals with critical limb ischemia.
abstract: OBJECTIVE
  To compare the results of percutaneous transluminal angioplasty (PTA) and bypass graft surgery (BGS) for the treatment of infrapopliteal lesions in individuals presenting with critical limb ischemia (CLI).
  
  
  METHODS
  A total of 48 infrapopliteal PTAs and 50 infrapopliteal BGS were compared retrospectively. All grafts used nonreversed saphenous vein in a single length as a substitute.
  
  
  RESULTS
  Secondary patency and limb salvage rates in 24 months for the surgical group were 64.7% and 73.2%, respectively. For PTA group, these values were 63.7% and 68.2%, without differences between groups (log rank; P = .45 and .39, respectively). Bypass graft surgery presented better results of secondary patency (72.9% vs 57.1%) and limb salvage (83.5% vs 53.6%) than PTA for patients with Transatlantic Inter-Society Consensus (TASC) D lesions (P = .04 and P = .01, respectively).
  
  
  CONCLUSIONS
  Both BGS and PTA provided similar results of patency and limb salvage for individuals with infrapopliteal atherosclerotic disease presenting with CLI. Bypass graft surgery had better results than PTA when TASC D lesions were present.
authors: Division of Vascular Surgery, São Paulo State Public Servants Hospital, São Paulo, Brazil. ivancasel@uol.com.br
authors: Ivan Benaduce
authors: IB
authors: Casella
authors: Francisco Cardoso
authors: FC
authors: Brochado-Neto
authors: Giuliano de Almeida
authors: Gde A
authors: Sandri
authors: Marcelo Jorge
authors: MJ
authors: Kalaf
authors: Marcos Roberto
authors: MR
authors: Godoy
authors: Vinicius Scalco
authors: VS
authors: Costa
authors: Marcelo Fernando
authors: MF
authors: Matielo
authors: Roberto
authors: R
authors: Sacilotto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000401:mortality; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D001938:Brazil; D003251:Constriction, Pathologic; D016638:Critical Illness; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D018579:Patient Selection; D011150:Popliteal Artery / Q000503:physiopathology / Q000601:surgery*; D016016:Proportional Hazards Models; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation*; D013997:Time Factors; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000009:adverse effects / Q000401:mortality; D014654:Vascular Patency