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Clinical Outcomes of Subintimal vs. Intraluminal Revascularization Approaches for Long Femoropopliteal Occlusions in a Korean Multicenter Retrospective Registry Cohort.

 Kyu Kim  ;  Young-Guk Ko  ;  Chul-Min Ahn  ;  Pil-Ki Min  ;  Jae-Hwan Lee  ;  Chang-Hwan Yoon  ;  Cheol Woong Yu  ;  Seung Whan Lee  ;  Sang-Rok Lee  ;  Seung Hyuk Choi  ;  Yoon Seok Koh  ;  In-Ho Chae  ;  Donghoon Choi 
 CIRCULATION JOURNAL, Vol.82(7) : 1900-1907, 2018 
Journal Title
Issue Date
Chronic total occlusion ; Femoropopliteal artery ; Peripheral artery disease ; Revascularization ; Subintimal angioplasty
BACKGROUND: There are limited data comparing the outcomes of subintimal vs. intraluminal approach in the treatment of long femoropopliteal artery occlusions. The objective of this study was to investigate the efficacy and safety of the subintimal approach for long femoropopliteal artery occlusions.Methods and Results:From a multicenter retrospective registry cohort, we included a total of 461 patients with 487 femoropopliteal artery occlusions classified as Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC) II C/D for this analysis. We compared the immediate and mid-term outcomes of subintimal vs. intraluminal approaches. There were 228 patients with 243 limbs in the subintimal group, and 233 patients with 244 limbs in the intraluminal group. Baseline clinical and lesion characteristics were comparable between the 2 groups. The technical success rate was significantly higher in the subintimal group than in the intraluminal group (95.1% vs. 89.8%, P=0.041). The clinical primary patency (67.5% vs. 73.4% at 12 months, 54.0% vs. 61.3% at 24 months; P=0.086) and target lesion revascularization (TLR)-free survival (89.5% vs. 86.3% at 12 months, 77.6% vs. 76.0% at 24 months; P=0.710) did not differ significantly between the subintimal and the intraluminal groups. CONCLUSIONS: In long femoropopliteal occlusions, the subintimal approach achieved a higher technical success rate and similar mid-term primary patency and TLR-free survival compared with intraluminal approach.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Kyu(김규)
Min, Pil Ki(민필기) ORCID logo https://orcid.org/0000-0001-7033-7651
Ahn, Chul-Min(안철민) ORCID logo https://orcid.org/0000-0002-7071-4370
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
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