Journal «Angiology and Vascular Surgery» •
2018 • VOLUME 24 • №4
Comparing efficacy of recanalization with stenting of extended occlusions of superficial femoral artery and loop endarterectomy
Saaya Sh.B., Gostev A.A., Cheban A.V., Rabtsun A.A., Karpenko A.A.
Centre of Vascular and Hybrid Surgery, National Medical Research Centre named after Academician E.N. Meshalkin under the RF Public Health Ministry, Novosibirsk, Russia
Objective. The study was aimed at comparing the outcomes of loop endarterectomy (LE) and endovascular revascularization (ER) with stenting in occlusive lesions (TASC II type D) of the superficial femoral artery (SFA), as well as revealing predictors of restenosis/reocclusion.
Patients and methods. Between May 2011 and December 2016, a total of 234 patients presetting with occlusions of the SFA (TASC II type D lesions) were operated on. Of these, 117 patients underwent ER with SFA stenting and 117 patients were subjected to loop endarterectomy from the SFA. The obtained findings were analysed with the help of statistical methods using the Statistica 10 software package (StatSoft, USA). The level of deviation of the null hypothesis of no between-group differences was assumed at p<0.05.
Results. Technical success in the ER group amounted to 94% (110 of 117 patients) and in the LE group to 90% (105 of 117 patients). The length of postoperative hospital stay in the ER group was 4 days and in the LE group – 7.5 days (p<0.05). There were significantly more complications in the LE group as compared with ER group (p=0.04). No significant difference was revealed for the number of reocclusions/restenosis between groups – 9 (8.1%) cases in the ER group vs 10 (9.1%) cases in the LE group (p=0.83).
Conclusion. Loop endarterectomy is a safe, effective and feasible procedure in TASC II type D lesions of the SFA, being not inferior by patency to endovascular treatment during 12 months of follow up; however, it is associated with a high risk for the development of local complications and increased number of postoperative bed-days.
KEY WORDS: loop endarterectomy, endovascular recanalization, occlusive lesions of the superficial femoral artery.
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