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Endovascular therapy effective for treating type C/D femoropopliteal lesions
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Technical success rates were similar for endovascular treatment of two femoropopliteal lesion types, with no significant difference in major procedural complications or serious clinical events during follow-up, according to recent findings.
However, endovascular therapy for TransAtlantic Inter-Society Consensus II type C/D femoropopliteal lesions yielded a higher incidence of overall procedural complications and major adverse limb events vs. endovascular therapy for TransAtlantic Inter-Society Consensus II type A/B femoropopliteal lesions, researchers wrote.
In the multicenter, retrospective study, researchers evaluated 159 consecutive patients (179 limbs) who were treated with endovascular therapy for de novo femoropopliteal lesions between February 2008 and November 2012.
Eligible participants were categorized into group one (TransAtlantic Inter-Society Consensus II [TASC-II] type A and B; 105 limbs; n = 96) or group two (TASC-II type C and D; 74 limbs; n = 63). The researchers collected demographic, angiographic and procedural data on all patients from the medical records from individual hospitals. They compiled follow-up data from hospital records and through contact with patients.
The study’s primary endpoint was major adverse limb events, defined as a composite of target lesion revascularization, symptom relapse with abnormal ankle-brachial index or major amputation. Technical success was defined as < 30% residual diameter stenosis on angiogram after the procedure.
The researchers found that patients in group two had more complex lesion characteristics vs. group one, but there was no significant difference in the initial technical success rate (group two, 95.7%; group one, 96.2%; P = .45) between the two groups. Group two had a higher procedure-related complication rate vs. group one (26.4% vs. 6.8%; P <.001). Group one had four cases with flow-limited dissection, whereas group two had 17 cases. Each group had one case of no-reflow phenomenon, and group one had one arterial perforation. However, neither group had major complications necessitating urgent surgical correction or massive transfusion, the researchers wrote.
At 12 months, group two had a lower rate of major adverse limb event-free survival vs. group one (63.8% vs. 78.2%; P = .039). Kaplan-Meier analysis revealed that group two also had lower long-term major adverse limb event-free survival vs. group one (log-rank test, P = .039). Relapse of claudication was the most prevalent major adverse limb event, and this event was more common in group 2 (34.3% vs. 18.8%; P = .031). The two groups had very low and similar incidence of resting pain, amputation or bypass graft operation.
“Although there was a higher incidence of overall procedural complications and [major adverse limb event], the technical success rate for [endovascular therapy] for TASC-II C/D [femoropopliteal lesions] was comparable to [endovascular therapy] for TASC-II A/B [femoropopliteal lesions] without an increase in major procedural complications or serious clinical events during follow-up,” the researchers wrote. “Therefore, [endovascular therapy] could be a feasible primary approach for TASC-II C/D lesions undergoing repeated TLR.” – by Jennifer Byrne
Disclosure: The researchers report no relevant financial disclosures.
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