Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
Peripheral Vascular Disease
Comparison of Long-Term Outcome After Endovascular Therapy Versus Bypass Surgery in Claudication Patients With Trans-Atlantic Inter-Society Consensus-II C and D Femoropopliteal Disease
Hideaki AiharaYoshimitsu SogaShinsuke MiiJin OkazakiTerutoshi YamaokaDaisuke KamoiYoshiaki ShintaniToshinobu Ishikawaon behalf of the RECANALISE Registry Investigators
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2014 Volume 78 Issue 2 Pages 457-464


Background: Although endovascular therapy (EVT) has advanced, few reports have compared EVT and bypass surgery in claudication patients with femoropopliteal disease. The present study used data from a multicenter registry in Japan to analyze outcomes of EVT and bypass surgery for claudication patients with Trans-Atlantic Inter-Society Consensus (TASC)-II C and D femoropopliteal lesions. Methods and Results: Of 1,156 patients who underwent revascularization, 696 patients were treated for intermittent claudication. A total of 263 patients with femoropopliteal lesion were classified into TASC-II C and D. The primary and secondary patency rates of the EVT and bypass surgery groups were analyzed. The overall complication rate was 14.4% in the bypass surgery group and 3.5% in the EVT group (P<0.01). The 1- and 5-year primary patency rates were 82.1% and 69.4% in the bypass surgery group and 67.8% and 45.2% in the EVT group, respectively. Although the bypass surgery group had a higher primary patency rate than the EVT group (P<0.01, log-rank test), secondary patency rates did not differ significantly between the two groups. Conclusions: Although bypass surgery is clearly feasible for claudication patients with TASC-II C and D femoropopliteal disease, EVT is also a good option because of its lower complication rate and good secondary patency rate in patients in poor condition for bypass.  (Circ J 2014; 78: 457–464)

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