Endovascular Recanalization of Native Chronic Total Occlusions in Patients with Failed Lower-Extremity Bypass Grafts

Wrigley, C.; Vance, Ansar Z.; Niesen, Timothy J.; Grilli, C.; Velez, J. Daniel; Agriantonis, D.J.; Kimbiris, G.; Garcia, Mark J.; Leung, Daniel A.

doi:10.1016/j.jvir.2014.06.005

Cited by 6 publications

(5 citation statements)

References 18 publications

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“…Li Z (Li et al 2018 ) described a technical success rate of 95.6 %, a secondary patency rate of 61 % at 3 years and a limb salvage rate of 95 % at 3 years. In other case series, secondary patency rates at 1 year ranged from 44 to 96 % and limb salvage rates were 65–96 % at 2 years (Kawarada and Yokoi 2010 ; Yin et al 2015 ; Wrigley et al 2014 ).…”

Section: Discussionmentioning

confidence: 93%

Endovascular recanalization of chronic total occlusions of the native superficial femoral artery after failed femoropopliteal bypass in patients with critical limb ischemia

Minici

Ammendola

Talarico³

et al. 2021

CVIR Endovasc

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Background Femoropopliteal bypass occlusions are a significant issue in patients with critical limb ischemia and chronic total occlusion of the native superficial femoral artery, which challenges vascular surgeons and interventional radiologists. Performing a secondary femoropopliteal bypass is still considered the standard of care, although it is associated with a higher complication rate and lower patency rate in comparison with primary bypass. Over the past few years, angioplasty has been commonly used, with the development in endovascular technologies, to treat chronic total occlusions of the native superficial femoral artery, with a good technical success rate and clinical prognosis. The purpose of the study is to assess the outcome of endovascular recanalization of chronic total occlusions of the native superficial femoral artery, in patients unfit for surgery with critical limb ischemia after failed femoropopliteal bypass. Results A total of 54 patients were treated. 77.8 % of the conduits were PTFE grafts; the remainder were single-segment great saphenous veins. The most common clinical presentation was rest pain. Technical success was achieved in 51 (94.4 %) of 54 limbs. Angiographically, 77.8 % of the lesions were TASC II category D, while 22.2 % were TASC II category C. The average length of the native SFA lesions was 26.8 cm. Clinical success, with improved Rutherford classification staging, followed each case of technical success. The median follow-up value was 5.75 years (IQR, 1.5–7). By Kaplan-Meier survival analysis, primary patency rates were 61 % (± 0.07 SE) at 1 year and 46 % (± 0.07 SE) at 5 years. Secondary patency rates were 93 % (± 0.04 SE) at 1 year and 61 % (± 0.07 SE) at 5 years. Limb salvage rates were 94 % (± 0.03 SE) at 1 year and 88 % (± 0.05 SE) at 5 years. Conclusions The endovascular recanalization of chronic total occlusions (CTO) of the native superficial femoral artery (SFA) after a failed femoropopliteal bypass is a safe and effective therapeutic option in patients unfit for surgery with critical limb ischemia.

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Section: Discussionmentioning

confidence: 93%

Endovascular recanalization of chronic total occlusions of the native superficial femoral artery after failed femoropopliteal bypass in patients with critical limb ischemia

Minici

Ammendola

Talarico³

et al. 2021

CVIR Endovasc

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“…The technical success rates were ranging from 89% to 100% and limb salvage rates were 81-94% and 65-96% at 1-and 2-years of follow-up. [14][15][16][29][30][31] One-year primary and secondary patency rates in those studies ranged from 16% to 60% and from 44% to 96%, respectively. [14][15][16]30,31 And the rates of repeated intervention were between 38% and 50%.…”

Section: Discussionmentioning

confidence: 99%

“…[14][15][16][29][30][31] One-year primary and secondary patency rates in those studies ranged from 16% to 60% and from 44% to 96%, respectively. [14][15][16]30,31 And the rates of repeated intervention were between 38% and 50%. [30][31] These published data affirmed that percutaneous recanalization of native occlusions in failed bypass grafts is a considerable alternative with acceptable limb salvage rates.…”

Section: Discussionmentioning

confidence: 99%

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Recanalization of native superficial femoral artery chronic total occlusion after failed femoropopliteal bypass in patients with critical limb ischemia

Feng

Zhao

et al. 2017

J Interven Cardiology

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Objectives This study aimed to examine the outcomes of endovascular recanalization for native superficial femoral artery (SFA) chronic total occlusion (CTO) in patients with critical limb ischemia (CLI) after femoropopliteal bypass failure with limited surgical revascularization options. Background Endovascular recanalization of native artery occlusions has been recently used as a new alternative for threatened limbs after bypass graft occlusion. The feasibility and efficacy has not been widely reported. Methods We retrospectively analyzed 45 consecutive patients (45 limbs) undergoing endovascular recanalization of native SFA occlusion following failed femoropopliteal bypass between June 2010 and December 2016. Results All limbs had Transatlantic Inter‐Society Consensus class C (26.7%, 12/45) or D (73.3%, 33/45) lesions with a mean lesion length of 29.8 cm. The technical success rate was 95.6% (43/45 limbs). The ABI showed a significant increase from 0.3 ± 0.1 pre‐procedure to 0.7 ± 0.1 post‐procedure (P < 0.01). Two early (<30 days) below‐knee amputations due to acute thrombotic ischemia occurred during perioperative period and resulted in one death due to myocardial infarction. The mean follow‐up was 42.7 months (1‐62 months). Two patients were lost to follow up. The primary patency rates at 12 and 36 months were 54% and 51%, respectively. Secondary patency rates at 12 and 36 months were 78% and 61%, respectively. Limb salvage rate was 95% and amputation‐free survival rate was 88% at both 12 and 36 months. Conclusion Recanalization of native SFA CTO due to failed femoropopliteal bypass offers a feasible and safe alternative to surgical reconstruction with acceptable limb salvage.

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“…d Wrigley et al 17 described AFS rates of 87% at 12 months and 60% at 24 months, respectively, after endovascular intervention on the native circulation after a failed bypass graft.…”

Section: Journal Of Vascular Surgerymentioning

confidence: 99%

Outcomes of native superficial femoral artery chronic total occlusion recanalization after failed femoropopliteal bypass

El-Sayed

2017

Journal of Vascular Surgery

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Endovascular Recanalization of Native Chronic Total Occlusions in Patients with Failed Lower-Extremity Bypass Grafts

Cited by 6 publications

References 18 publications

Endovascular recanalization of chronic total occlusions of the native superficial femoral artery after failed femoropopliteal bypass in patients with critical limb ischemia

Endovascular recanalization of chronic total occlusions of the native superficial femoral artery after failed femoropopliteal bypass in patients with critical limb ischemia

Recanalization of native superficial femoral artery chronic total occlusion after failed femoropopliteal bypass in patients with critical limb ischemia

Outcomes of native superficial femoral artery chronic total occlusion recanalization after failed femoropopliteal bypass

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