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Mid-Term Outcomes of Endovascular Treatment for TASC-II D Femoropopliteal Occlusive Disease with Critical Limb

Álvaro Torres-Blanco1, Gemma Edo-Fleta2, Francisco Gómez-Palonés2

  • 1Department of Angiology, Endovascular and Vascular Surgery, Hospital Universitario Dr. Peset, Av/Gaspar Aguilar 90, 46017, Valencia, Spain. atorres658@yahoo.es.

Cardiovascular and Interventional Radiology
|July 24, 2015
PubMed

Insights

Endovascular treatment for Trans-Atlantic Inter-Society Consensus II (TASC-II) D femoropopliteal occlusions in critical limb ischemia (CLI) patients is safe and effective. While restenosis necessitates follow-up, this minimally invasive approach offers good outcomes.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Interventions

Background:

  • Critical limb ischemia (CLI) poses significant challenges, often linked to complex femoropopliteal occlusions.
  • Trans-Atlantic Inter-Society Consensus II (TASC-II) D lesions represent the most challenging category of femoropopliteal disease.

Purpose of the Study:

  • To evaluate the safety and midterm effectiveness of endovascular treatment for TASC-II D femoropopliteal occlusions in patients with CLI.
  • To assess outcomes including limb salvage, revascularization rates, and patency.

Main Methods:

  • Retrospective analysis of 32 CLI patients with TASC-II D femoropopliteal occlusions treated between 2008-2013.
  • Data included lesion characteristics, interventions (stent, stent-graft, angioplasty), and clinical outcomes.
  • Kaplan-Meier and Cox analyses assessed limb salvage, freedom from target lesion revascularization (TLR), and freedom from target extremity revascularization (TER).

Main Results:

  • 35 TASC-II D occlusions were treated in 32 patients (mean age 76, 80% with tissue loss).
  • 2-year freedom from TLR and TER rates were 41% and 76%, respectively.
  • Primary and secondary patency rates at 2 years were 41% and 79%, with 7 major amputations and 6 deaths during follow-up.

Conclusions:

  • Endovascular treatment for TASC-II D lesions in CLI patients is safe and yields satisfactory midterm results.
  • A minimally invasive approach is beneficial for this patient group.
  • Regular follow-up is crucial due to a high rate of restenosis, necessitating further long-term efficacy studies.
Abstract

Keywords:
EndovascularFemoropoplitealLimb ischemiaPeripheral artery diseaseRevascularizationStenting

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