title: Comparison of long-term outcome after endovascular therapy versus bypass surgery in claudication patients with Trans-Atlantic Inter-Society Consensus-II C and D femoropopliteal disease.
abstract: BACKGROUND
  Although endovascular therapy (EVT) has advanced, few reports have compared EVT and bypass surgery in claudication patients with femoropopliteal disease. The present study used data from a multicenter registry in Japan to analyze outcomes of EVT and bypass surgery for claudication patients with Trans-Atlantic Inter-Society Consensus (TASC)-II C and D femoropopliteal lesions.
  
  
  RESULTS
  Of 1,156 patients who underwent revascularization, 696 patients were treated for intermittent claudication. A total of 263 patients with femoropopliteal lesion were classified into TASC-II C and D. The primary and secondary patency rates of the EVT and bypass surgery groups were analyzed. The overall complication rate was 14.4% in the bypass surgery group and 3.5% in the EVT group (P<0.01). The 1- and 5-year primary patency rates were 82.1% and 69.4% in the bypass surgery group and 67.8% and 45.2% in the EVT group, respectively. Although the bypass surgery group had a higher primary patency rate than the EVT group (P<0.01, log-rank test), secondary patency rates did not differ significantly between the two groups.
  
  
  CONCLUSIONS
  Although bypass surgery is clearly feasible for claudication patients with TASC-II C and D femoropopliteal disease, EVT is also a good option because of its lower complication rate and good secondary patency rate in patients in poor condition for bypass.
authors.affiliation: Department of Cardiology, Tsukuba Medical Center Hospital.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Aihara
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Soga
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Mii
authors.forename: Jin
authors.initials: J
authors.lastname: Okazaki
authors.forename: Terutoshi
authors.initials: T
authors.lastname: Yamaoka
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kamoi
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Shintani
authors.forename: Toshinobu
authors.initials: T
authors.lastname: Ishikawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D066254:Axillofemoral Bypass Grafting / Q000009:adverse effects / Q000379:methods; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods; D005500:Follow-Up Studies; D007383:Intermittent Claudication / Q000601:surgery; D058729:Peripheral Arterial Disease / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D003245:Consensus Statements as Topic