학술대회 안내 사전등록 안내 초록등록 안내 초록등록/관리 숙박및교통 안내


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ǥ : ȣ - 490160   96 
Efficacy of Subintimal Angioplasty Combined with Stenting In Long Femoropolpliteal Artery Occlusive Lesions: Comparison with Conventional Intraluminal Angioplasty
Yonsei Cardiovascular Center, Yonsei University College of Medicine
Young-Guk Ko, Dong-Hoon Choi, Yangsoo Jang, Won-Heum Shim
Background: Subintimal angioplasty of long superficial femoral artery (SFA) was reported to be feasible with relatively high success rates, however there is a skepticism about its long term clinical outcomes. However, no clinical studies comparing subintimal and intraluminal angioplasty of lower limb arteries are currently available. We investigated clinical and hemodynamic outcomes of the patients who underwent subintimal angioplasty (SA) during the period of March, 2003 to June 2004 and compared them with those of the patients from our registry database who had intraluminal angioplasty (IA) during the period of January, 2001 to February, 2003. Methods: A total of 102 patients (age 65.4±8.9 years, male n=81) with long (> 10 cm) SFA occlusive lesions including 57 patients (62 limbs) in SA group and 45 patients (50 limbs) in IA group were investigated. Results: All baseline clinical and angiographical characteristics showed no significant difference. Critical limb ischemia was present in 36 limbs (32.1%). Most patients had comorbidities such as DM (61.8%), hypertension (66.7%) and significant CAD (69.6%). Multi-segmental limb arterial obstructive lesions were present in 58.8%. Mean lesion length was 21.5±7.6 cm. Implantation of at least one self-expandable stent (diameter 7.4±1.3 mm, length 71.3±16.6 mm) was performed in all patients. In SA group, stents were always implanted at the proximal entry site into subintimal channel. SA was successful in 59 of 62 limbs (95.2%), whereas technical success rate for IA was 86.0% (43 of 50 limbs) (p=NS). In both groups, there were no immediate procedure-related complications requiring surgery. The residual pressure gradient over the treated segment was 7.8±6.2 mmHg in SA group and 9.8 ±6.5 mmHg in IA group (p=NS). Primary patency at 12 months was 79.7% in SA group and 60.5% in IA group (p=0.034). Repeat percutaneous revascularization was required in 5 patients of SA group and in 8 patients of IA group. Conclusion: SA combined with stenting was feasible with a high technical success rate and achieved good short and mid-term results for revascularization of long segment lower limb artery occlusions than IA.


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