Angioplasty for femoral artery occlusion: comparison with surgery

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Endovascular Therapy

Background:

• Superficial femoral artery occlusions pose a significant challenge in peripheral artery disease management.
• Treatment options include angioplasty and femoropopliteal bypass grafting, each with distinct outcomes.
• Optimal treatment selection depends on lesion characteristics and available graft materials.

Purpose of the Study:

• To compare the efficacy and long-term patency of percutaneous transluminal angioplasty versus femoropopliteal bypass grafting for superficial femoral artery occlusions.
• To evaluate the impact of lesion length on angioplasty success and patency rates.
• To assess the performance of different bypass graft types in femoropopliteal reconstructions.

Main Methods:

• Retrospective analysis of 46 patients undergoing percutaneous transluminal angioplasty for superficial femoral artery occlusions (1-20 cm).
• Comparison with 133 patients who underwent femoropopliteal bypass grafting during the same period.
• Life table analysis used to determine 1- and 2-year patency rates for both treatment groups.

Main Results:

• Percutaneous transluminal angioplasty achieved a primary success rate of 76% with a 1-year patency of 56.8%.
• Angioplasty success was significantly influenced by lesion length, with better outcomes for shorter occlusions (4 cm).
• Femoropopliteal bypass grafts showed a 1-year patency of 60.2% and 2-year patency of 42.1%, with poorer performance noted for non-saphenous vein grafts.

Conclusions:

• Percutaneous transluminal angioplasty is the preferred treatment for short superficial femoral artery occlusions.
• For longer occlusions, angioplasty is a viable option when saphenous vein grafts are not utilized.
• Treatment choice should consider lesion length and the availability of autologous saphenous vein for bypass procedures.