Author + information
- Apurva Patela,b,
- Roosha Parikha,b,
- Robert Bellavicsa,b,
- John Coppolaa,b,
- Joseph Pumaa,b,
- Olivier Bertranda,b,
- Zoltán Ruzsaa,b and
- Tak Kwana,b
Background: Improved equipment and techniques have resulted in transition from surgical bypass/transfemoral endovascular intervention to radial (TR) or pedal (TP) artery as the access for intervention of superficial femoral artery (SFA) chronic total occlusion (CTO). The feasibility, efficacy and safety between TPA and TRA for treatment of SFA-CTO have not been compared.
Methods: We performed intention to treat analysis on prospectively collected data of 140 SFA CTO interventions in 121 patients from 01/2014 to 09/2016 using either primary TRA or TPA (operator discretion) at two institutions. Primary end point was 30 day major adverse event (MAE) – death, amputation or target vessel revascularization.
Results: Primary TRA was used in 35 patients (Rutherford class 3-6 91%) with 35 CTO lesions (TASCII A 43%, B 34%, C 6%, D 17%). Primary TPA was used in 84 patients (Rutherford class 3-6 100%) with 105 CTO lesions (TASCII A 6%, B 18%, C 33%, D 43%). Primary crossing success rate was higher with TRA compared to TPA (86% vs 53%, p=0.006). With TPA the use of a second access site (TRA) was required in 49 lesions resulting in an higher overall procedural success of 98% vs 89% in TRA group (p=0.04) (Figure). The 30 day MAE was 6 % (2 deaths) in TRA group vs 0% in TPA group (p=0.06). There were no vascular complication in both groups and access sites were patent, confirmed by ultrasound.
Conclusions: The treatment of SFA CTO is feasible and safe using both TRA or TPA approach providing high success rates and no access site complications.
Moderated Poster Contributions
Interventional Cardiology Moderated Poster Theater, Poster Hall, Hall C
Sunday, March 19, 2017, 10:00 a.m.-10:10 a.m.
Session Title: Peripheral Arterial Disease, Risk, and Outcomes
Abstract Category: 18. Interventional Cardiology: Carotid and Endovascular Intervention
Presentation Number: 1306M-05
- 2017 American College of Cardiology Foundation