Efficacy and safety of endovascular treatment for femoropopliteal lesions of TASC II type C and D compared with TASC II type A and B in Korea

Abstract

Objective To compare the long-term safety and clinical efficacy of endovascular treatment for TASC-II type C/D femoropopliteal lesion compared with TASC-II type A/B femoropopliteal lesion in Korea. Methods A total of 179 limbs [TASC-II A/B femoropopliteal lesion (group I, n = 105 limbs) and TASC-II C/D (group II, n = 74 limbs)] were retrospectively analyzed from patients who underwent angioplasty with or without primary stent implantation between February 2008 and November 2012 at two medical centers in South Korea. The major adverse limb event was defined as a composite of target lesion revascularization, symptom relapse with abnormal ankle brachial index, and major amputation. Results Immediate procedural success rates were not significantly different (96.2% vs. 95.7%, p = 0.450). Although major adverse limb event, mainly driven by symptom relapse with abnormal ankle brachial index, were significantly higher in group II ( p = 0.013), the incidence of major amputation was very low and similar in both groups. Conclusion Even though there were higher incidences of overall procedural complication and major adverse limb event, the technical success rate of endovascular treatment for TASC-II C/D femoropopliteal lesion was comparable to endovascular treatment for TASC-II A/B FPL without an increase in major procedural complications or serious clinical events during follow-up.

Assessment of the relation between C-reactive protein to albumin ratio and the severity and complexity of peripheral arterial disease

“…7 TASC-II classification guides decision-making regarding the more accurate treatment strategy between endovascular treatment and vascular graft surgery; endovascular treatment is more favorable for TASC-II A and B lesions than for TASC-II C and D lesions. 9 The clinical efficacy of TASC-II for predicting prognoses has been assessed in numerous trials showing that TASC-II C and D lesions had a poor prognosis and were related to more procedural complications and major adverse limb events. [8][9][10] Determining the parameters that are related to the severity and complexity of PAD may improve the prognosis by evaluating the patients more comprehensively for early diagnosis.…”

“…9 The clinical efficacy of TASC-II for predicting prognoses has been assessed in numerous trials showing that TASC-II C and D lesions had a poor prognosis and were related to more procedural complications and major adverse limb events. [8][9][10] Determining the parameters that are related to the severity and complexity of PAD may improve the prognosis by evaluating the patients more comprehensively for early diagnosis. In our study, age, walking distance, ABI, TG, and CAR were found to be associated with severe and complex PAD lesions.…”

“…7 Clinical studies have shown that TASC-II classification has prognostic importance in PAD and provides valuable information regarding the selection of a revascularization strategy (endovascular or surgical). 8,9 However, the relationship between CAR and the severity and complexity of PAD is not yet known. Because PAD is an essentially inflammatory disease, we hypothesized that CAR could be indicative of the complexity and severity of PAD as assessed by TASC-II classification.…”

“…7 Clinical studies have shown that TASC-II classification has prognostic importance in PAD and provides valuable information regarding the selection of a revascularization strategy (endovascular or surgical). 8 , 9…”

Diagnostic Impact of Immunonutritional Indices in Peripheral Arterial Disease Severity and Complexity

“…The increased prevalence of PAD in recent years, in addition to classical risk factors, hypertension, dyslipidemia, smoking, is believed to be mainly attributable to aging populations and the growing prevalence of risk factors, especially diabetes mellitus (5). However, traditional risk factors do not entirely describe the excess risk of PAD.…”