Improved technical success and midterm patency with subintimal angioplasty compared to intraluminal angioplasty in long femoropopliteal occlusions

Young Guk Ko, Jung Sun Kim, Donghoon Choi, Yangsoo Jang, Won Heum Shim

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Purpose: To compare the efficacy of subintimal angioplasty combined with primary stenting to intraluminal angioplasty with stenting for revascularization of long (>10 cm) femoropopliteal arterial occlusions. Methods: Baseline characteristics and outcomes of 52 patients (40 men; mean age 65.6±9.7 years) with superficial femoral artery (SFA) occlusions in 61 limbs (mean occlusion length 22.7±9.9 cm) treated with subintimal angioplasty and primary stenting were compared with a 54-patient control group (46 men; mean age 64.8±8.2 years) from our registry database who had intraluminal angioplasty with stenting in 60 limbs (mean occlusion length 22.0±8.5 cm). Results: All baseline clinical and angiographic characteristics showed no differences. In all patients, at least 1 self-expanding nitinol stent was implanted. Subintimal angioplasty was successful in 58 (95.1%) of 61 limbs, whereas technical success for the conventional approach was 86.7% (52/60 limbs; p = 0.11). In both groups, there were no major complications requiring surgery. Primary patency at 12 months for successful cases was 76.4% for subintimal angioplasty and 59.2% for conventional angioplasty (p=0.06); on an intention-to-treat basis, including technical failures, the rates were 72.4% and 50.9%, respectively (p=0.02). Conclusion: Subintimal angioplasty combined with stenting was feasible, with a high technical success rate and better short and midterm results for revascularization of long femoropopliteal occlusions than the conventional intraluminal approach.

Original languageEnglish
Pages (from-to)374-381
Number of pages8
JournalJournal of Endovascular Therapy
Volume14
Issue number3
DOIs
Publication statusPublished - 2007 Jun 1

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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