Abstract
OBJECTIVE: Techniques for surgical repair of Trans-Atlantic Inter-Society Consensus (TASC) C and D lesions of the superficial femoral artery (SFA) are supragenicular bypass grafting or the less invasive remote endarterectomy (RSFAE). This trial compares the patency rates of both techniques.
DESIGN: Randomized, multicenter trial.
MATERIALS AND METHODS: 116 patients were randomized to RSFAE (n=61) and supragenicular bypass surgery (n=55). Indications for surgery were claudication (n=77), rest pain (n=21), or tissue loss (n=18).
RESULTS: Median hospital stay was 4 days in the RSFAE group compared with 6 days in the bypass group (p=0.004). Primary patency after 1-year follow-up was 61% for RSFAE and 73% for bypass (p=0.094). Secondary patency was 79% for both groups. Subdividing between venous (n=25) and prosthetic grafts (n=30) shows a primary patency of 89% and 63% respectively at 1-year follow-up (p=0.086).
CONCLUSION: RSFAE is a minimally invasive adjunct in the treatment of TASC C and D lesions of the SFA, with shorter admittance and a comparable secondary patency rate to bypass. The venous bypass is superior to both RSFAE and PTFE bypass surgery, but only 45% of patients had a sufficient saphenous vein available. This study is registered with ClinicalTrials.gov, number NCT00566436.
Original language | English |
---|---|
Pages (from-to) | 68-76 |
Number of pages | 9 |
Journal | European Journal of Vascular and Endovascular Surgery |
Volume | 37 |
Issue number | 1 |
DOIs | |
Publication status | Published - Jan 2009 |
Externally published | Yes |
Keywords
- Adult
- Aged
- Aged, 80 and over
- Arterial Occlusive Diseases/surgery
- Blood Vessel Prosthesis Implantation
- Endarterectomy
- Female
- Femoral Artery
- Humans
- Male
- Middle Aged
- Vascular Patency