Femoro-popliteal bypass versus remote endarterectomy: a propensity matched analysis.

Autor:	Shoraan SB; Department of Vascular and Hybrid Surgery, National Medical Research Center, Ministry for Public Health Care of Russian Federation, Novosibirsk, Russia - shoraans@gmail.ru., Gostev AA; Department of Vascular and Hybrid Surgery, National Medical Research Center, Ministry for Public Health Care of Russian Federation, Novosibirsk, Russia., Osipova OS; Department of Vascular and Hybrid Surgery, National Medical Research Center, Ministry for Public Health Care of Russian Federation, Novosibirsk, Russia., Cheban AV; Department of Vascular and Hybrid Surgery, National Medical Research Center, Ministry for Public Health Care of Russian Federation, Novosibirsk, Russia., Ignatenko PV; Department of Vascular and Hybrid Surgery, National Medical Research Center, Ministry for Public Health Care of Russian Federation, Novosibirsk, Russia., Starodubtsev VB; Department of Vascular and Hybrid Surgery, National Medical Research Center, Ministry for Public Health Care of Russian Federation, Novosibirsk, Russia., Karpenko AA; Department of Vascular and Hybrid Surgery, National Medical Research Center, Ministry for Public Health Care of Russian Federation, Novosibirsk, Russia.
Jazyk:	angličtina
Zdroj:	International angiology : a journal of the International Union of Angiology [Int Angiol] 2024 Jun; Vol. 43 (3), pp. 358-366. Date of Electronic Publication: 2024 Jul 11.
DOI:	10.23736/S0392-9590.24.05216-7
Abstrakt:	Background: The purpose of this study was to compare femoropopliteal bypass (FPB) and remote endarterectomy (RE) for long femoropopliteal lesions. Methods: Single center retrospective propensity matching analysis of the symptomatic patients with long occlusion of the femoro-popliteal segment (>250 mm), who underwent femoro-popliteal bypass above the knee or remote endarterectomy from 2014 to 2020. Primary endpoints: primary patency (PP), secondary patency (SP), target lesion revascularization (TLR). Secondary endpoints: MALE, MACE, clinical improvement and survival. Results: Four hundred patients were divided into two groups: 200 in the FPB group and 200 in the RE group. As a result of propensity score matching, 110 (FPB) and 109 (RE) patients remained. Three-year primary patency rates were 62% for FPB vs. 53% for RE, P=0.16. Secondary patency rates were 84% for FPB vs. 75% for RE, P=0.10. Freedom from TLR were 61% for FPB vs. 71% for RE P=0.21. Survival and amputation-free survival (AFS) also did not differ (93% vs. 94%, P=0.81 and 87% vs. 92%, P=0.19 respectively). Primary patency of the GSV higher than RE (P=0.00) and PTFE (P=0.00). It was established statistically advantages of RE and great saphenous vein (GSV) bypass over a PTFE bypass in SP (P=0.01 P=0.03), TLR (P=0.02 P=0.00) and AFS (P=0.03 P=0.01). Conclusions: Surgical treatment of long femoropopliteal occlusions with an autovenous bypass or remote endarterectomy showed significantly better results in secondary patency, TLR and AFS than the use of PTFE prostheses. GSV remains the gold standard for femoropopliteal bypass surgery.
Databáze:	MEDLINE
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