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Home > Vascular Annual Meeting^® > PP36. Outcome Following Loss of Primary Patency...

PP36. Outcome Following Loss of Primary Patency After Endovascular Intervention of Superficial Femoral and Popliteal Arteries

Maciej L. Dryjski1,2, Monica O'Brien-Irr2, Hasan Dosluoglu1, Linda Harris.1,2
1University at Buffalo, Buffalo, NY; 2Kaleida Health, Buffalo, NY

OBJECTIVES: To evaluate outcomes following loss of primary patency (LPP) in superficial femoral (SFA) and popliteal (Pop) arteries treated by endovascular intervention (EVI)

METHODS: The medical records of all SFA/Pop EVI performed by 2 Vascular Surgeons between 2005- 2008 were reviewed to identify LPP defined as occlusion or need for re-intervention documented by duplex or angiography. TASC II, EVI type, Rutherford Score (RS) and Rutherford Improvement Scores (RIS) were recorded. Analysis was completed with SPSS 15.

RESULTS: LPP occurred in 38 patients (31%) at 8.6±5.4 months. Twenty-four (63%) of these patients had EVI for critical limb ischemia (Rutherford Class 4-6). Mean follow up (FU) was 20±11 months. Neither TASC II, RS at primary EVI (PEVI) or EVI type had significant impact on RIS at LPP. RIS at LPP was worse than before PEVI in 55%. Re-intervention was performed in 79% of LLP patients. Patients who never showed significant improvement between PEVI and LPP were unlikely to improve at FU (Table I) despite a trend to undergo multiple re-interventions (55% vs. 13%; p=0.06). Survival and limb salvage at 24 months were 75% and 92%. Healing occurred in 46% of tissue loss patients at 11.9±11.6 months.

CONCLUSIONS: EVI of the SFA/Pop arteries are not benign procedures. LPP occurred in nearly 1/3 of patients and 55% of those patients became worse than prior to PEVI. Despite reasonable limb salvage, healing occurred in only 46% and was delayed. Aggressive re-intervention after PLL may not improve outcome in patients who did not demonstrate significant interval improvement after PEVI.

AUTHOR DISCLOSURES: M.L. Dryjski, None; M. O'Brien-Irr, None; H. Dosluoglu, None; L. Harris, None.

Table 1.