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Failed superficial femoral artery intervention for advanced infrainguinal occlusive disease has a significant negative impact on limb salvage. Journal Article
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| Authors: | Al-Nouri, O.; Krezalek, M.; Hershberger, R.; Halandras, P; Gassman, A.; Aulivola, B; Milner, R. |
| Article Title: | Failed superficial femoral artery intervention for advanced infrainguinal occlusive disease has a significant negative impact on limb salvage. |
| Abstract: | OBJECTIVE: Endovascular treatment of superficial femoral artery (SFA) lesions is a well-established practice. The repercussions of failed SFA interventions are unclear. Our goal was to review the efficacy of SFA stenting and define negative effects of its failure. METHODS: A retrospective chart review was conducted from January 2007 to January 2010 that identified 42 limbs in 39 patients that underwent SFA stenting. Follow-up ankle-brachial index and a duplex ultrasound scan was performed at routine intervals. RESULTS: Mean patient age was 68 years (range, 43-88 years); there were 22 men (56%) and 17 women (44%). Intervention indication was claudication in 15 patients (36%), rest pain in seven patients (17%), and tissue loss in 19 patients (45%). There were 15 patients (36%) with TransAtlantic Inter-Society Consensus (TASC) A, nine patients (21%) with TASC B, five patients (12%) with TASC C, and 13 patients (31%) with TASC D lesions. The majority of lesions intervened on were the first attempt at revascularization. Three stents (7.7%) occluded within 30 days. One-year primary, primary-assisted, and secondary patency rates were 24%, 44%, and 51%, respectively. Limb salvage was 93% during follow-up. Seventeen interventions failed (40%) at 1 year. Of these, seven patients (41%) developed claudication, seven patients (41%) developed ischemic rest pain, and three patients (18%) were asymptomatic. During follow-up, three patients (7.7%) required bypass and three patients (7.7%) major amputation, one after failed bypass. All limbs requiring bypass or amputation had TASC C/D lesions. Thirty-day and 1-year mortality was 2.6% and 10.3%, respectively. CONCLUSIONS: Interventions performed for TASC C/D lesions are more likely to fail and more likely to lead to bypass or amputation. Interventions performed for TASC C/D lesions that fail have a negative impact on limb salvage. This should be considered when performing stenting of advanced SFA lesions. Copyright Copyright 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved. |
| Journal Title: | Journal of vascular surgery |
| Volume: | 56 |
| Issue: | 1 |
| ISSN: | 1097-6809; 0741-5214 |
| Publisher: | Mosby, Inc |
| Journal Place: | United States |
| Date Published: | 2012 |
| Start Page: | 106 |
| End Page: | 110 |
| Language: | English |
| DOI/URL: | |
| Notes: | ID: 12521; Record Owner: From MEDLINE, a database of the U.S. National Library of Medicine.; Status: MEDLINE; Comments: Comment in: J Vasc Surg. 2012 Jul;56(1):111-2; PMID: 22749265; Publishing Model: Journal available in: Print-Electronic Citation processed from: Internet; NLM Journal Code: kd2, 8407742; Electronic Date of Publication: 20120105; Entry Date: 20120920 |
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