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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
Giornale Italiano di Chirurgia Vascolare 1999 June;6(2):93-103
language: English, Italian
Indications and limitations of endovascular surgery in the infrageniculate district
Domanin M., Lorenzi G., Gabrielli L., Costantini A., Molinari A., Sala P., Agrifoglio G.
From the Institute of Vascular Surgery and Angiology University of Milan, Italy
Aims. A retrospective analysis of the results of endovascular therapy in the treatment of primary and postoperative lesions of the distal arteries.
Methods. The study included 55 patients undergoing endovascular treatment of the infrageniculate popliteal artery, the tibial arteries or previous femorodistal bypasses. The population was subdivided on the basis of the association or otherwise with revascularisation surgery (28 (51.0%) vs 27 (49.0%)), or on the basis of redo surgery or primary operations (21 (38.1%) vs 34 (61.9%)).
Results. Immediate technical success was achieved in 67.3% of cases with a patency of 38.2% after 2 years. In terms of endovascular procedures alone, clinical success was achieved in 78.1% and 53.0% after 2 years. In endovascular procedures associated with conventional surgery, immediate patency was 62.5% (p<0.001) and 16.2% at 2 years (p<0.001). In primary procedures, immediate clinical success was obtained in 73.9% and 48.3% at 2 years. The immediate result of redo procedures was 52.2% (p<0.001) and 19.2% at 2 years (p<0.001). Limb salvage in the event of redo surgery was achieved in 82.6% immediately after surgery and 61.4% at 2 years, compared to 87.5% (n.s.) immediately after surgery and 68.6% at 2 years (n.s.) in primary surgery.
Conclusions. Segmentary primary lesions can be treated with good results in terms of immediate and long-term patency, whereas in the case of associated procedures or redo surgery, the results are valid if evaluated in terms of limb salvage.