Outcomes of endovascular treatment for patients with TASC II D femoropopliteal occlusive disease: A single center study

Abstract

Background: Advances in endovascular technology led to an alternative treatment option for TASC II D (TransAtlantic Inter-Society Consensus II class D) lesions. This study was aimed to evaluate the outcomes of endovascular treatment for TASC II D femoropopliteal lesions. Methods: Endovascular intervention with bare nitinol stent implantation was performed on 58 limbs (53 patients) with TASC II D femoropopliteal lesions from January 2011 to March 2013. Kaplan-Meier curves of primary patency, assisted patency and second patency were performed. Predictive factors of re-stenosis/occlusion were evaluated by univariate methods. Results: Total 53 patients with mean age of 74.2±8.2 (range, 58.0-91.0 years) and mean lesion length of 314.8±64.3 mm (188.2-400.4 mm) were enrolled. The mean follow-up time was 12.2±6.1 months (5-38 months). Revascularization was successfully on 95 % lesions by bare nitinol stent implantation. Primary patency rates at 1, 2 and 3 years were 63 %, 12 % and 12 %, respectively. Assisted primary patency rates at 1, 2 and 3 years were 77 %, 31 % and 31 %, respectively. Secondary patency rates at 1, 2 and 3 years were 96 %, 63 % and 63 %. During one-year follow-up, no major amputation was occurred. Univariate analysis revealed that number of run-off vessels was a potential predictor of re-stenosis/occlusion. Conclusion: Endovascular treatment of TASC II D femoropopliteal artery occlusion has a high technical success rate with acceptable one-year patency rate. The long-term outcomes are poor, but endovascular intervention could be a good alternative for patients unsuitable for surgical bypass.