title: A single-center retrospective analysis of patency rates of intraluminal versus subintimal endovascular revascularization of long femoropopliteal occlusions.
abstract: OBJECTIVE
  The evaluation of patency rates of intraluminal versus subintimal endovascular revascularization of long femoropopliteal (FP) lesions.
  
  
  BACKGROUND
  Chronic total occlusions (CTO) of the FP artery in peripheral interventions are crossed either with a support catheter-guidewire based technique or subintimal dissection and re-entry device assisted approach. Both techniques have a high procedural success rate, but their long term patency is not well studied. There is also lack of comparative data addressing the patency of long non-CTO vs. CTO occlusions.
  
  
  METHODS
  We performed a single center retrospective analysis, studying the patency rates in 215 patients (254 limbs) with TASC C and D FP lesions treated with stents. There were 3 patient groups: without CTO (non-CTO); CTO crossed using support catheter and guide-wire (CTO-SW) and CTO crossed with a re-entry device (CTO-RE).
  
  
  RESULTS
  There were 155 limbs in CTO-SW group; 50 in CTO-RE group and 49 in non-CTO. Lesion length (mean±SD) was 251.81±7.48mm in CTO-SW group; 280±13.18mm in CTO-RE group and 248.77±13.31 in non-CTO group (p=non-significant). In-stent restenosis (ISR) at a mean follow-up of 19.26±16.14months did not differ between groups occurring in 23 (47%) limbs in non-CTO; 66 (42%) in CTO-SW; and 24 (48%) in CTO-RE. Smoking and stent fracture were predictors of ISR by multivariate analysis.
  
  
  CONCLUSIONS
  In patients with long FP lesions, ISR rates were similar between patients with and without CTO. In the CTO group mid-term vessel patency was not affected by the crossing technique utilized.
authors.affiliation: New York University Department of Medicine, Division of Cardiology. Electronic address: anvar.babaev@nyumc.org.
authors.forename: Anvar
authors.initials: A
authors.lastname: Babaev
authors.affiliation: New York University Department of Medicine, Division of Cardiology.
authors.forename: Pawan
authors.initials: P
authors.lastname: Hari
authors.affiliation: New York University Department of Medicine, Division of Cardiology.
authors.forename: Rohit
authors.initials: R
authors.lastname: Gokhale
authors.affiliation: New York University Department of Medicine, Division of Cardiology.
authors.forename: Susanna
authors.initials: S
authors.lastname: Zavlunova
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D003251:Constriction, Pathologic / Q000601:surgery; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery*; D011474:Prosthesis Design; D012189:Retrospective Studies; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology; D014656:Vascular Surgical Procedures
keywords: Chronic total occlusion; In-stent restenosis; Peripheral arterial disease