Abstract

NAU, Gerardo et al. Long-term Outcome of Femoropopliteal Chronic Total Occlusion Percutaneous Treatment. Rev. argent. cardiol. [online]. 2015, vol.83, n.5, pp.446-449. ISSN 1850-3748.

Background: The endovascular approach of peripheral vascular disease is currently the treatment of choice in patients with severely limited functional status. Chronic total occlusions (CTO) are lesions that pose a great challenge both for the clinician and the interventionist. Objective: The aim of this study was to analyze the feasibility and long-term outcome in CTO patients undergoing percutaneous intervention. Methods: From January 2008 to July 2013, consecutive patients with at least one chronic total occlusion of the femoropopliteal segment, undergoing elective or urgent percutaneous intervention, were included in the study. Demographic, angiographic and technical aspects were analyzed and clinical long-term follow-up was performed by telephone or medical contact. Results: From a total of 431 treated patients, 129 presented with femoropopliteal CTO. TASC A-B lesions accounted for 62.8% of cases and TASC C-D lesions for 37.2%. Stents were implanted in 62.7% of patients and complementary techniques were used in 22% (change of access, reentry catheters, microdissection). Angiographic success of the procedure was 85.2%. Clinical improvement of 782.2 meters in the walking distance (25-75% interquartile range: 391-1,173) was obtained in the successfully treated patients. In the multivariate analysis, run-off (OR 3.71, 95% CI 1.01-9.65; p=0.048) was the only independent success variable. During the 623-day follow-up period (25-75% interquartile range: 430.7-1,292.2) 20 reinterventions (15.5%) and 3 intervention-unrelated amputations were performed. Conclusions: Percutaneous CTO treatment in the femoropopliteal territory is feasible in a high proportion of patients, with significant improvement in walking distance. The long-term outcome is associated with a significant rate of reinterventions.

Keywords : Arterial Occlusive Diseases; Femoral Artery; Popliteal Artery; Angioplasty.