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Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
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Femoro-popliteal bypass versus remote endarterectomy: a propensity matched analysis

Saaya B Shoraan1, Alexander A Gostev2, Olesya S Osipova2

  • 1Department of Vascular and Hybrid Surgery, National Medical Research Center, Ministry for Public Health Care of Russian Federation, Novosibirsk, Russia - shoraans@gmail.ru.

International Angiology : a Journal of the International Union of Angiology
|July 11, 2024
PubMed

Insights

Femoropopliteal bypass (FPB) and remote endarterectomy (RE) showed comparable outcomes for long femoropopliteal lesions. Great saphenous vein (GSV) bypass and RE demonstrated superior results compared to PTFE bypass for secondary patency and revascularization.

Area of Science:

  • Vascular Surgery
  • Endovascular Procedures
  • Surgical Outcomes Analysis

Background:

  • Long femoropopliteal occlusions present a significant challenge in peripheral artery disease treatment.
  • Femoropopliteal bypass (FPB) and remote endarterectomy (RE) are surgical options for these complex lesions.

Purpose of the Study:

  • To compare the effectiveness of femoropopliteal bypass (FPB) versus remote endarterectomy (RE) for treating long femoropopliteal lesions.
  • To evaluate outcomes including primary and secondary patency, and target lesion revascularization.

Main Methods:

  • Retrospective analysis of symptomatic patients with femoro-popliteal segment occlusions (>250 mm) from 2014-2020.
  • Propensity score matching was used to compare patients undergoing FPB (above the knee) with those undergoing RE.
  • Primary endpoints included primary patency (PP), secondary patency (SP), and target lesion revascularization (TLR).

Main Results:

  • Three-year primary patency rates were 62% for FPB vs. 53% for RE (P=0.16).
  • Secondary patency rates were 84% for FPB vs. 75% for RE (P=0.10).
  • Great saphenous vein (GSV) bypass and RE showed statistically significant advantages over PTFE bypass in SP, TLR, and amputation-free survival (AFS).

Conclusions:

  • Surgical treatment using autovenous bypass (GSV) or RE demonstrated superior secondary patency, TLR, and AFS compared to PTFE prostheses.
  • GSV bypass remains the preferred method for femoropopliteal bypass surgery due to its favorable outcomes.
Abstract

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