Coexistent Bilateral Femoral Artery Occlusion, does It Mean More Advanced Atherosclerosis Compare to Unilateral Lesion?

Park, Ki Hyuk

Abstract

PURPOSE: The finding of superficial femoral artery lesions is the most prevalent atherosclerotic lesion identified in peripheral arterial diseases, interventions are provided with a variety of modalities. Many prior studies have shown that patients with leg artery occlusion have serious comorbidity risks such as stroke and ischemic heart disease. In this study we evaluated the clinical significance of the presence of coexistent bilateral femoral artery occlusion to determine clinical significance and comorbidities.
METHODS
From 1999 to 2005, there were 213 patients undergoing femoro-popliteal artery bypass for superficial femoral artery occlusion at institution. TASC type B, C lesions were included in this study. We retrospectively analyzed the medical records of 193 patients. Comorbidities, long term graft patency, limb salvage and survival rates were compared between two groups: Group I (115 patients with unilateral lesion) and Group II (77 patients with bilateral lesion). In addition, the natural history of the contralateral limb of patients in Group I were studied.
RESULTS
The mean age of Group I and II was 70.5+/-9.3 and 73.0+/-8.2. Diabetes, hypertension, cerebrovascular disease, ischemic heart disease in group I., vs II were: 33.0%, vs. 33.8%, 32.2%, vs. 33.8%, 13.9%, vs. 14.3%, 7.0%, vs. 22.1% respectively; the P-values were 0.91, 0.81, 0.94, 0.002 for each condition respectively. The six-year graft patency, limb salvage and survival rate for group I vs. group II was: 71.58% vs. 69.58%, 86.51% vs. 85.92%, 75.98% vs. 70.95% with p-values of 0.35, 0.58, 0.19. For patients in group I 10.4% (12/115) developed contralateral femoral artery occlusion during a seven year follow up period.
CONCLUSION
Ischemic heart disease was significantly higher in patients with bilateral femoral artery occlusion which contributed to perioperative risk. However, no significant difference was identified for long term patency, limb salvage or survival between the two groups.