Comparison of Results of Subintimal Angioplasty and Percutaneous Transluminal Angioplasty in Superficial Femoral Artery Occlusions

ObjectivesTo report results of subintimal angioplasty (SA) of superficial femoral artery occlusions and to compare these results with percutaneous transluminal angioplasty (PTA) of similar lesions.DesignProspective study.PatientsIn the period from June 2002 to August 2006, 73 SA procedures were performed in 71 patients and 75 PTA procedures were performed in 75 patients.MethodsAll cases treated with SA or PTA for superficial femoral artery occlusions were prospectively registered and reviewed. Assessments of comorbidities, indication for procedure, run-off, occlusion length, calcification of the artery and graft patency were recorded.ResultsThe technical success rate of SA was 87.7% versus 81.3% for PTA. Primary patency rates in the SA group at 1, 6, 12, 24 months were respectively 84.9 ± 4.2, 71.2 ± 5.1, 68.5 ± 5.3 and 65.8 ± 5.2%; in the PTA group – 81.3 ± 4.4, 45.3 ± 5.7, 42.7 ± 5.6 and 38.7 ± 5.5% respectively. At the same time-points primary assisted patency rates were in SA group 84.9 ± 4.2, 83.6 ± 4.2, 71.2 ± 5.2 and 68.5 ± 5.3%; and in the PTA group 81.3 ± 4.4, 62.5 ± 5.5, 44 ± 5.6 and 42.7 ± 5.6%. Calcification was associated with SA failure. There were no amputations in the follow up of either SA or PTA procedures.ConclusionResults from subintimal angioplasty of superficial femoral artery occlusions was superior to the results of PTA.