Abstract
(1) Background: Both open surgery and endovascular strategies are accepted methods for the treatment of critical limb ischemia (CLI) due to superficial femoral artery disease (SFA). There is currently only one randomized trial results (BASIL-1) that compared open vs. endo procedures for SFA treatment. In this study, we wanted to compare two treatment strategies for superficial femoral artery vascular disease. (2) Material and methods: A study was conducted on 235 patients (part of a national project—“Development of the public infrastructure research and development and creation of new infrastructure”) in which the open vs. endovascular strategy was compared in patients with critical limb ischemia and SFA disease. (3) Results: Primary outcomes are the time elapsed until major events related to the index leg or death. Secondary outcomes are amputation-free survival rate, reintervention on the index leg, major cardiovascular events and postoperative complications. (4) Conclusion: After 6 months, we had an overall mortality rate of 7.23% and an amputation-free survival of 89.36%.
Highlights
Peripheral arterial disease (PAD) is currently considered a global pandemic that affected, in 2010, approximately 200 million patients [1]
(2) Material and methods: A study was conducted on 235 patients in which the open vs. endovascular strategy was compared in patients with critical limb ischemia and superficial femoral (SFA) disease
The 2017 European Society for Cardiology (ESC) Guidelines recommendations on revascularization of superficial femoral (SFA) occlusive lesions are that an endovascular strategy should be attempted first for short lesions of under 25 cm [3,4]
Summary
Peripheral arterial disease (PAD) is currently considered a global pandemic that affected, in 2010, approximately 200 million patients [1]. Superficial femoral artery disease was, for decades, treated by open surgery. The 2017 ESC Guidelines recommendations on revascularization of superficial femoral (SFA) occlusive lesions are that an endovascular strategy should be attempted first for short lesions of under 25 cm (class I level C) [3,4]. The research aims to evaluate the comparison of endovascular vs open surgery treatment strategies in patients with critical limb ischemia for the final purpose of limb salvages that are fit for both revascularization procedures (bypass surgery or endovascular strategy). The results presented in this study show that, for surgical bypass is a more effective and durable option for patients with low post-operative morbidity and mortality, but has longer hospitalization and higher wound complication rate
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