Femoropopliteal Angioplasty: Short and Mid-Term Results: Results of a Cohort of 270 Cases

Background: Percutaneous endovascular therapy is becoming a primary option for managing femoropopliteal occlusive disease. The purpose of this study was to evaluate the mid-term results of endovascular treatment of femoropopliteal arterial disease and to identify predictor factors for success. Method(s): Records and observations of patients having had a femoropolitteal angioplasty procedure between January 2012 and January 2018 were studied. Inclusion criteria – Femoropopliteal angioplasty performed for stenosing and / or occlusive atheromatous lesions. Exclusion criteria: (1) Associated supra-crural surgery. (2) Aneurysmal pathology. (3) Absence of angiographic exploration. Result(s): Femoropopliteal percutaneous transluminal angioplasty was performed on 270 consecutive limbs (265 patients). The average age of our patients was 62.2 In our study, 87.6% of patients had critical limb ischemia. Lesions were classified as Trans-Atlantic Inter-Society Consensus (TASC) A (43%), B (43%), C (7%), and D (7%). Femoropopliteal interventions included simple balloon angioplasty in 117 cases (43.2%), and use of at least one stent for the the remaining 153 cases (56.8%). Technical success was achieved in 98.7% of patients. We recorded three deaths and a major morbidity rate was 15%. The actuarial primary patency at 12 and 36 months was 65.4% and 40.2%, respectively. The actuarial primary limb preservation rate was 94.4 % at 12 months. Comparison between simple balloon angioplasty and the use of primary stenting show no difference in patency (P = 0.832) and limb salvage (P = 0.67). Negative predictors of primary patency determined by univariate analysis included popliteal location (P < 0.001) and TASC D (P < 0.001). However, diabetes mellitus (P = 0.001) and poor run off (P < 0.001) were the principal predictive factors of limb loss. Conclusion(s): Femoropopliteal angioplasty can be performed with a low morbidity and mortality. Intermediate primary patency is directly related to TASC classification and popliteal localization. Primary stenting dosen’t improve permeability and limb salvage.

 

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Publication History

Article published online:
11 May 2021