title: Subintimal recanalization plus stenting or bypass for management of claudicants with femoro-popliteal occlusions.
abstract: OBJECTIVE
  To assess a practice of claudicant revascularization with either subintimal angioplasty (SIA) plus stenting or femoropopliteal bypass.
  
  
  METHODS
  All claudicants related to femoropopliteal occlusions treated either with above-the-knee femoropopliteal (AKFP) bypass (group 1) or SIA and stent (group 2) between 2004 and 2011 were reviewed. The two groups were analyzed with regard to patency and freedom from re-intervention.
  
  
  RESULTS
  One hundred and fifty limbs were consecutively treated with AKFP bypass (n = 82), SIA plus stenting (n = 58), or SIA (n = 10). Bypasses were performed with synthetic grafts in 49 limbs (59.7%). Covered stents were used in 34 limbs (63%) and self-expandable stents in the remainder. Mean follow-up was 26 and 36 months, respectively, in group 1 and 2. At 24 months, primary, primary-assisted, and secondary patency for bypass versus SIA + stent groups was, respectively, 66.6 versus 70.1%, 76.5 versus 90.1%, and 88.2 versus 90.1%. Freedom from re-intervention rates at 12 and 36 months were, respectively, 78.8 and 68.4% for group 2 and 86.4% and 65.2% for group 1.
  
  
  CONCLUSIONS
  SIA plus stenting is an effective and useful option for the management of claudicants with femoropopliteal occlusions, and can be considered as complementary to surgical bypass.
authors.affiliation: Department of Vascular Surgery, University Hospital Nord, Marseille, France. mourad.boufi@ap-hm.fr
authors.forename: M
authors.initials: M
authors.lastname: Boufi
authors.forename: A
authors.initials: A
authors.lastname: Azghari
authors.forename: K
authors.initials: K
authors.lastname: Belahda
authors.forename: A D
authors.initials: AD
authors.lastname: Loundou
authors.forename: O
authors.initials: O
authors.lastname: Hartung
authors.forename: Y S
authors.initials: YS
authors.lastname: Alimi
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007383:Intermittent Claudication / Q000000981:diagnostic imaging / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency
keywords: Bypass; Claudication; Femoropopliteal occlusions; Stent; Subintimal recanalization