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Angioplasty and Primary Stenting of High-grade, Long-segment Superficial Femoral Artery Disease: Is It Worthwhile?

  • Original Article
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Annals of Vascular Surgery

Abstract

The purpose of this study was to determine the long-term results and efficacy of angioplasty and stenting of long-segment, high-grade superficial femoral artery disease. Seventy-three consecutive primary balloon angioplasty procedures with immediate stenting in 70 patients with SVS/ISCVS grade B2 or C superficial femoral artery (SFA) disease exceeding 5 cm in length were evaluated. The mean lesion length was 16 cm and occlusion constituted 62%, with a runoff score of 8. Forty-nine procedures (67%) were performed for critical ischemia. A total of 135 stents were placed. Follow-up was with 3-month duplex ultrasound; stenosis >50% was considered the end point for failure. Mean follow-up time was 26 months. Initial technical success with intent to treat was 90%. Initial success according to anatomic, hemodynamic, and clinical criteria was 90%, 88%, and 88%, respectively, with intent to treat. Limb salvage in the critical ischemia group was 71%. Overall cumulative primary patency rates at 12, 24, and 48 months were 56%, 35%, and 22%, and secondary patency rates were 69%, 47%, and 37%, respectively. A stented segment length >10 cm and procedure in claudicants incurred an inferior patency rate. Treatment of high-grade SFA lesions with angioplasty and primary setting results in lower long-term patency rate than those with surgery, but combined with secondary interventions this treatment option may be an acceptable alternative in selected patients with critical ischemia. Femoropopliteal bypass remains the procedure of choice.

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References

  1. A-M Löfberg S Karacagil C Ljungman et al. (2001) ArticleTitlePercutaneous transluminal angioplasty of the femoropopliteal arteries in limbs with chronic critical lower limb ischemia. J Vasc Surg 34 114–121 Occurrence Handle10.1067/mva.2001.113486 Occurrence Handle11436083

    Article  PubMed  Google Scholar 

  2. M Cejna S Thurnher H Illiasch et al. (2001) ArticleTitlePTA versus Palmaz stent placement in femoropopliteal artery obstructions: a multicenter prospective randomized study. J Vasc Interv Radiol 12 23–31 Occurrence Handle1:STN:280:DC%2BD3M3ls1OktQ%3D%3D Occurrence Handle11200349

    CAS  PubMed  Google Scholar 

  3. IL Gordon RM Conroy M Arefi et al. (2001) ArticleTitleThree-year outcome of endovascular treatment of superficial femoral artery occlusion. Arch Surg 136 221–228 Occurrence Handle10.1001/archsurg.136.2.221 Occurrence Handle1:STN:280:DC%2BD3M7ptlentQ%3D%3D Occurrence Handle11177146

    Article  CAS  PubMed  Google Scholar 

  4. Z Zdanowski U Albrechtsson A Lundin et al. (1999) ArticleTitlePercutaneous transluminal angioplasty with or without stenting for femoropopliteal occlusions? A randomized controlled study. Int Angiol 18 251–255 Occurrence Handle1:STN:280:DC%2BD3c3mvFKnug%3D%3D Occurrence Handle10811511

    CAS  PubMed  Google Scholar 

  5. MJ Pentecost MH Criqui G Dorros et al. (1994) ArticleTitleGuidelines for peripheral percutaneous transluminal angioplasty of the abdominal aorta and lower extremity vessels. Circulation 89 511–531 Occurrence Handle1:STN:280:ByuC3cbgs1U%3D Occurrence Handle8281692

    CAS  PubMed  Google Scholar 

  6. RA Cambria MM Farooq MW Mewissen et al. (1999) ArticleTitleEndovascular therapy of iliac arteries: routine application of intraluminal stents does not improve clinical patency. Ann Vasc Surg 13 599–605 Occurrence Handle10.1007/s100169900306 Occurrence Handle1:STN:280:DC%2BD3c%2FgvFWqtw%3D%3D Occurrence Handle10541614

    Article  CAS  PubMed  Google Scholar 

  7. D Vroegindeweij LD Vos AV Tielbeek et al. (1997) ArticleTitleBalloon angioplasty combined with primary stenting versus balloon angioplasty alone in femoropopliteal obstructions: a comparative randomized study. Cardiovasc Intervent Radiol 20 420–425 Occurrence Handle10.1007/s002709900186 Occurrence Handle1:STN:280:DyaK1c%2Fit1yntA%3D%3D Occurrence Handle9354709

    Article  CAS  PubMed  Google Scholar 

  8. SS Ahn RB Rutherford GJ Becker et al. (1993) ArticleTitleReporting standards for lower extremity arterial endovascular procedures. J Vasc Surg 17 1103–1107 Occurrence Handle10.1067/mva.1993.45889 Occurrence Handle1:STN:280:ByyB1c%2Fnsl0%3D Occurrence Handle8505790

    Article  CAS  PubMed  Google Scholar 

  9. RE Parsons WD Suggs JJ Lee et al. (1998) ArticleTitlePercutaneous transluminal angioplasty for the treatment of limb threatening ischemia: do the results justify an attempt before bypass grafting? J Vasc Surg 28 1066–1071 Occurrence Handle1:STN:280:DyaK1M%2FmtFyrug%3D%3D Occurrence Handle9845658

    CAS  PubMed  Google Scholar 

  10. LA Karch MA Mattos JP Henretta et al. (2000) ArticleTitleClinical failure after percutaneous transluminal angioplasty of the superficial femoral and popliteal arteries. J Vasc Surg 31 880–888 Occurrence Handle1:STN:280:DC%2BD3c3ms1ahsw%3D%3D Occurrence Handle10805877

    CAS  PubMed  Google Scholar 

  11. J Golledge K Ferguson M Ellis et al. (1999) ArticleTitleOutcome of femoropopliteal angioplasty. Ann Surg 229 146–153 Occurrence Handle10.1097/00000658-199901000-00019 Occurrence Handle1:STN:280:DyaK1M7itVKrtQ%3D%3D Occurrence Handle9923812

    Article  CAS  PubMed  Google Scholar 

  12. B Axisa G Fishwick A Bolia et al. (2002) ArticleTitleComplications following peripheral angioplasty. Ann R Coll Surg Engl 84 39–42 Occurrence Handle1:STN:280:DC%2BD387mtFCqtg%3D%3D Occurrence Handle11892730

    CAS  PubMed  Google Scholar 

  13. GS Treiman L Ichikawa RL Treiman et al. (1994) ArticleTitleTreatment of recurrent femoral or popliteal artery stenosis after pereutaneous transluminal angioplasty. J Vasc Surg 20 577–587 Occurrence Handle1:STN:280:ByqD3MfotlQ%3D Occurrence Handle7933259

    CAS  PubMed  Google Scholar 

  14. RM Wolfram B Pokrajac R Ahmadi et al. (2001) ArticleTitleEndovascular brachytherapy for prophylaxis against restenosis after long-segment femoropopliteal placement of stents: initial results. Radiology 220 724–729 Occurrence Handle1:STN:280:DC%2BD3MvotlagsQ%3D%3D Occurrence Handle11526274

    CAS  PubMed  Google Scholar 

  15. SH Duda B Pusich G Richter et al. (2002) ArticleTitleSirolimus-eluting stents for the treatment of obstructive superficial femoral artery disease: six month results. Circulation 106 1505–1509 Occurrence Handle10.1161/01.CIR.0000029746.10018.36 Occurrence Handle1:CAS:528:DC%2BD38XntVKksbk%3D Occurrence Handle12234956

    Article  CAS  PubMed  Google Scholar 

  16. J Grimm S Muller-Hulsbeck T Jahnke et al. (2001) ArticleTitleRandomized study to compare PTA alone versus PTA with Palmaz stent placement for femoropopliteal lesions. J Vasc Interv Radial 12 935–942 Occurrence Handle1:STN:280:DC%2BD3MvktFOrsw%3D%3D

    CAS  Google Scholar 

  17. SR Walker SW Yusuf BR Hopkinson (1998) ArticleTitleA 10-year follow-up of patients presenting with ischaemic rest pain of the lower limbs. Eur J Vasc Endovasc Surg 15 478–482 Occurrence Handle1:STN:280:DyaK1czisVSltA%3D%3D Occurrence Handle9659881

    CAS  PubMed  Google Scholar 

  18. A Albäck F Biancari S Schmidt et al. (1998) ArticleTitleHemodynamic results of femoropopliteal percutaneous transluminal angioplasty. Eur J Vasc Endovasc Surg 16 7–12 Occurrence Handle9715710

    PubMed  Google Scholar 

  19. G Bauermeister (2001) ArticleTitleEndovascular stent-grafting in the treatment of superficial femoral artery occlusive disease. J Endovasc Ther 8 315–320 Occurrence Handle1:STN:280:DC%2BD3MvksFKrug%3D%3D Occurrence Handle11491267

    CAS  PubMed  Google Scholar 

  20. D Rosenthal PJ Schubart EV Kinney et al. (2001) ArticleTitleRemote superficial femoral artery endarterectomy: multicenter medium-term results. J Vasc Surg 34 428–432 Occurrence Handle10.1067/mva.2001.116300 Occurrence Handle1:STN:280:DC%2BD3MvptVOgtA%3D%3D Occurrence Handle11533593

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, The University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China

    Stephen W. K. Cheng MS, FRCS, FACS, Albert C. W. Ting MBBS, FRCS & Pei Ho MBBS, FRCS

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  1. Stephen W. K. Cheng MS, FRCS, FACS
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  2. Albert C. W. Ting MBBS, FRCS
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  3. Pei Ho MBBS, FRCS
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Corresponding author

Correspondence to Stephen W. K. Cheng MS, FRCS, FACS.

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Cheng, S.W., Ting, A.C. & Ho, P. Angioplasty and Primary Stenting of High-grade, Long-segment Superficial Femoral Artery Disease: Is It Worthwhile? . Ann Vasc Surg 17, 430–437 (2003). https://doi.org/10.1007/s10016-003-0028-8

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  • DOI: https://doi.org/10.1007/s10016-003-0028-8

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