TY - JOUR

T1 - The effect of the stented iliac lesions TASC-II C, D on the femoropopliteal bypass patency: Propensity score-matched observational study

AU - Osipova, Olesia

AU - Cheban, Alexey

AU - Ignatenko, Pavel

AU - Ruzankin, Pavel

AU - Prokopenko, Evgeny

AU - Karpenko, Andrey

N1 - Funding Information: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The work of Pavel Ruzankin and Evgeny Prokopenko was supported by the Mathematical Center in Akademgorodok under agreement No. 075-15-2019-1675 with the Ministry of Science and Higher Education of the Russian Federation. Publisher Copyright: © The Author(s) 2021.

PY - 2022/6

Y1 - 2022/6

N2 - Introduction: Concurrent stenting of complex iliac lesions during infrainguinal bypasses can increase the complexity of a case and impact outcomes. Objective: Our aim was to evaluate the effect of inflow stenting of TASC-II C, D iliac lesions on femoropopliteal bypass patency. Methods: A retrospective observational cohort study of patients who underwent femoropopliteal bypass with TASC-II C, D iliac artery stenting (hybrid group) or without inflow lesions (non-hybrid group) was conducted. After propensity score matching, 120 patients were included in the non-hybrid group and 60 patients in the hybrid one. The median follow-up was 432 (193; 1313) days in the hybrid group and 472 (196; 1376) days in the non-hybrid group (p = 0.94). Results: No significant differences were found between the groups in 30-day morbidity and serious adverse events. At 3 years, primary and secondary bypass patency for the hybrid group and non-hybrid group were 62.2% versus 59.9% (p = 0.36) and 63.7% versus 64.3% (p = 0.077), respectively. The primary patency of the iliac stents in patients of the hybrid group was 95% at 3 years. The estimated hazard ratio for primary patency for hybrid versus non-hybrid was 0.77, with 90% CI: 0.50–1.21; the noninferiority upper bound being 1.31, which corresponds to a 10% additive noninferiority margin for probabilities. The 3 years of freedom from amputation in patients with chronic limb-threatening ischemia was 94.1% and 75.0% in the hybrid and non-hybrid groups, respectively (p = 0.09). Conclusion: The outcomes of the femoropopliteal bypass in hybrid surgery supplemented with stenting of TASC-II C, D iliac lesions was similar to femoropopliteal bypass with intact inflow arteries.

AB - Introduction: Concurrent stenting of complex iliac lesions during infrainguinal bypasses can increase the complexity of a case and impact outcomes. Objective: Our aim was to evaluate the effect of inflow stenting of TASC-II C, D iliac lesions on femoropopliteal bypass patency. Methods: A retrospective observational cohort study of patients who underwent femoropopliteal bypass with TASC-II C, D iliac artery stenting (hybrid group) or without inflow lesions (non-hybrid group) was conducted. After propensity score matching, 120 patients were included in the non-hybrid group and 60 patients in the hybrid one. The median follow-up was 432 (193; 1313) days in the hybrid group and 472 (196; 1376) days in the non-hybrid group (p = 0.94). Results: No significant differences were found between the groups in 30-day morbidity and serious adverse events. At 3 years, primary and secondary bypass patency for the hybrid group and non-hybrid group were 62.2% versus 59.9% (p = 0.36) and 63.7% versus 64.3% (p = 0.077), respectively. The primary patency of the iliac stents in patients of the hybrid group was 95% at 3 years. The estimated hazard ratio for primary patency for hybrid versus non-hybrid was 0.77, with 90% CI: 0.50–1.21; the noninferiority upper bound being 1.31, which corresponds to a 10% additive noninferiority margin for probabilities. The 3 years of freedom from amputation in patients with chronic limb-threatening ischemia was 94.1% and 75.0% in the hybrid and non-hybrid groups, respectively (p = 0.09). Conclusion: The outcomes of the femoropopliteal bypass in hybrid surgery supplemented with stenting of TASC-II C, D iliac lesions was similar to femoropopliteal bypass with intact inflow arteries.

KW - femoropopliteal bypass

KW - hybrid surgery

KW - iliac artery stenting

KW - non-inferiority trial

KW - propensity score methods

KW - Humans

KW - Risk Factors

KW - Treatment Outcome

KW - Femoral Artery/diagnostic imaging

KW - Propensity Score

KW - Retrospective Studies

KW - Popliteal Artery/diagnostic imaging

KW - Stents

KW - Vascular Patency

UR - http://www.scopus.com/inward/record.url?scp=85110268052&partnerID=8YFLogxK

UR - https://www.mendeley.com/catalogue/f1a9e4b5-ea2a-390b-adef-db8b0fa7cef9/

U2 - 10.1177/1358863X211021165

DO - 10.1177/1358863X211021165

M3 - Article

C2 - 34269143

AN - SCOPUS:85110268052

VL - 27

SP - 230

EP - 238

JO - Vascular Medicine (United Kingdom)

JF - Vascular Medicine (United Kingdom)

SN - 1358-863X

IS - 3

ER -