Three-year comparable clinical outcome for Trans-Atlantic Inter-Society Consensus (TASC) D femoropopliteal occlusion: Endovascular vs bypass surgery |
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Authors: | Skyi Yin-Chun Pang Rosanna Yin-Ting Chow Tiffany Ho-Yi Chan Ronald On-Ho Tse Stephen Wing-Keung Cheng |
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Institution: | 1. Division of Vascular Surgery, Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China;2. Division of Vascular Surgery, Department of Surgery, Queen Mary Hospital, Hong Kong SAR, China;3. Department of Radiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China |
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Abstract: | Aim To evaluate the difference between endovascular surgery and bypass/hybrid approach in treating Trans-Atlantic Inter-Society Consensus (TASC) D femoropopliteal occlusion. Patients and Methods This is a 10-year retrospective cohort study including 75 patients with TASC D femoropopliteal occlusion with revascularisation from 2009 to 2018. Cases were retrieved from the Clinical Data Analysis and Reporting System. Demographics, lesions characteristics, operative findings and follow-up data were reviewed. Results A total of 65% of patients had endovascular intervention, 23% open bypass and 12% hybrid operation. The endovascular group had fewer critical limb ischaemia (endovascular 43%, bypass 94%, hybrid 100%; P < .001), and shorter length of lesion (endovascular 26.4 cm vs bypass/hybrid 31.0 cm; P = .004). The technical success rate of the endovascular group was 87.8%. Different endovascular treatment strategies were used. The 12-month primary patency rate of the endovascular group was lower (endovascular 69.7% vs bypass 81.3% vs hybrid 75.0%; P = .67) but the secondary patency rate at 3 years after the operation was similar across all groups (endovascular 83.3% vs bypass 78.6% vs hybrid 87.5%; P = .86). Conclusion Endovascular treatment for long and complex femoropopliteal occlusion is technically feasible with a high success rate. Close surveillance with prompt reintervention may help achieve 3 years’ comparable patency of endovascular intervention to traditional surgical bypass. Individualised plan of revascularisation should be considered. |
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Keywords: | clinical practice endovascular treatment long femoropopliteal occlusion |
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