Revascularização arterial femoropoplítea suprapatelar em pacientes TASC C e D – comparação da cirurgia aberta com a técnica endovascular com múltiplos stents ou stent único

Abstract

Objective: the purpose of this analysis was to compare the above knee femoro poplíteal arterial revascularization with peripheral angioplasty using single or multiple stents or surgery for patients with TASC C and D femoral atherosclerotic lesions and critical limb ischaemia. Methods: retrospectively analysis of 75 patients gathered into three groups: A, B and C selected by the revascularization technique employed: Surgery or peripheral angioplasty with multiple or single stents. The ankle braquial index, Rutherford’s clinical classification before and after procedure, hyperplasia and patency analysis were reviewed in detail. Primary endpoints were amputation free survival and death. Results: the endpoint analysis among groups did not differ. Before and after procedure the ankle braquial index was associated with a statistical significant improvement in all groups (P-value < 0,001). Patency analysis among groups after 3, 6, and 12 months did not differ statistically. The Hyperplasia among the groups was higher in the multiple stent group (P-value < 0,001). Conclusion: hemodynamic improvement was observed in all three groups. The clinical status improvement was not so significative in the multiple stent group as was in the surgical and single stent groups. The tendency of using peripheral angioplasty with multiple stents for the treatment of patients with TASC C and D femoral atherosclerotic disease and critical limb ischaemia it is not justified yet.