Outcome after angioplasty versus bypass surgery in patients with superficial femoral artery lesions

Abstract

Background Management of patients with lower limb ischemia owing to superficial femoral artery lesions is very challenging, as there are two modalities for management, either with angioplasty or bypass surgery, after risk factor modification, exercise, and medical treatment. Every method has its advantages and disadvantages regarding patency, improvement of symptoms, and complications. Aim To compare the outcome after angioplasty versus bypass surgery in patients with superficial femoral artery lesions. Patients and methods During the period from July 2017 to May 2019, this study was carried out as an interventional prospective comparative study on 52 patients with superficial femoral artery lesion divided into two groups: group A and group B. The study was conducted in Vascular Surgery Unit, Department of Surgery Suez Canal University Hospital, to compare the outcome after angioplasty versus bypass surgery in patients with superficial femoral artery lesions. Results After 1-year follow-up, on comparison of both procedures, the results showed better patency rate in bypass surgery group (84.6%) than angioplasty group (61.5%). There was a slight decrease in ankle brachial index with time in bypass surgery group, with mean of 0.83±0.12, whereas in angioplasty group was 0.73±0.14. Symptoms showed better improvement in bypass surgery group than angioplasty group. Complications were higher in bypass surgery group (hematoma, wound infection, and thrombosis) than angioplasty group. Conclusion We found that bypass surgery had more complications but better results in patency and in improvement of symptoms. On the contrary, we found that angioplasty had less painful maneuver, less complications, and was suitable for high-risk patients, but had short time of patency.