Study Evaluates Endovascular Treatment for TASC II D Femoropopliteal Occlusive Disease With CLI

March 2, 2016—An assessment of safety and midterm outcomes of endovascular treatment for Trans-Atlantic Inter-Society Consensus (TASC) II D femoropopliteal occlusive disease in patients with critical limb ischemia (CLI) was published by Álvaro Torres-Blanco, MD, et al in CardioVascular and Interventional Radiology (2016;39:344–352).

The investigators selected patients with CLI who underwent endovascular treatment for TASC-D de novo femoropopliteal occlusive disease between September 2008 and December 2013. Collected data included anatomic features, pre- and postprocedure ankle-brachial index, duplex ultrasound, and periprocedural complications. Sustained clinical improvement, limb salvage rate, freedom from target lesion revascularization (TLR), and freedom from target extremity revascularization (TER) were assessed by Kaplan-Meier estimation and predictors of restenosis/occlusion with Cox analysis.

As summarized in CardioVascular and Interventional Radiology, 32 patients underwent treatment for 35 TASC-D occlusions. Mean age was 76 ± 9. Mean lesion length was 23 ± 5 cm. Twenty-eight limbs (80%) presented tissue loss. Seventeen limbs underwent treatment by stent, 13 by stent-graft, and five by angioplasty. Mean follow-up was 29 ± 20 months. Seven patients required major amputation and six patients died during follow-up. Eighteen endovascular and three surgical TLR procedures were performed due to restenosis or occlusion. Estimated freedom from TLR and TER rates at 2 years were 41% and 76%, whereas estimated primary and secondary patency rates were 41% and 79%, respectively.

According to their findings, the investigators concluded that endovascular treatment for TASC II D lesions is safe and offers satisfying outcomes, though emphasizing the need for follow-up due to a high rate of restenosis. Further follow-up is necessary to know the long-term efficacy of these procedures, stated the authors in CardioVascular and Interventional Radiology.