Comparison of results of subintimal angioplasty and percutaneous transluminal angioplasty in superficial femoral artery occlusions

Objectives: To report results of subintimal angioplasty (SA) of superficial femoral artery occlusions and to compare these results with percutaneous transluminal angioplasty (PTA) of similar lesions. Design: Prospective study. Patients: In the period from June 2002 to August 2006, 73 SA procedures were performed in 71 patients and 75 PTA procedures were performed in 75 patients. Methods: All cases treated with SA or PTA for superficial femoral artery occlusions were prospectively registered and reviewed. Assessments of comorbidities, indication for procedure, run-off, occlusion Length, calcification of the artery and graft patency were recorded. Results: The technical success rate of SA was 87.7% versus 81.3% for PTA. Primary patency rates in the SA group at 1, 6, 12, 24 months were respectively 84.9 +/- 4.2, 71.2 +/- 5. 1, 68.5 +/- 5.3 and 65.8 +/- 5.2%; in the PTA group -81.3 +/- 4.4, 45.3 +/- 5.7, 42.7 +/- 5.6 and 38.7 +/- 5.5% respectively. At the same time-points primary assisted patency rates were in SA group 84.9 +/- 4.2, 83.6 +/- 4.2, 71.2 +/- 5.2 and 68.5 +/- 5.3%; and in the PTA group 81.3 +/- 4.4, 62.5 +/- 5.5, 44 +/- 5.6 and 42.7 +/- 5.6%. Calcification was associated with SA failure. There were no amputations in the follow up of either SA or PTA procedures. Conclusion: Results from subintimal angioplasty of superficial femoral artery occlusions was superior to the results of PTA. (C) 2008 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.