Abstract：
Surgical thromboendarterectomy (TEA) is the standard treatment for an occlusive lesion of the common femoral artery (CFA). However, there is limited knowledge on the need for patch angioplasty in CFA TEA. The objective of this study was to compare the peri-operative and two year results of CFA TEA with or without patch angioplasty.
A multicentre retrospective observational study was performed at 34 Japanese centres. Comparisons were made between patients undergoing CFA TEA with or without patch angioplasty after propensity score matching (PSM). The primary endpoints were primary patency and freedom from target lesion revascularisation (TLR) of the TEA lesion. The secondary endpoints were hospital outcomes, limb salvage, and overall survival.
Between 2018 and 2020, 428 TEA procedures (237 with patch angioplasty and 191 with primary closure) were performed. PSM extracted 151 pairs with no significant intergroup differences in baseline characteristics. Peri-operative death and complications occurred in 0.7% vs. 1.3% (p = 1.0) and 6.0% vs. 6.6% (p = 1.0), respectively. The follow up rate was 96% over a median follow up of 14.9 months (interquartile range 8.3, 24.3). Loss of primary patency occurred in 18 patients. The two year primary patency of patch angioplasty cases was statistically significantly higher than that of primary closure cases (97.0% vs. 89.9%; p = .021). TLR was performed in 14 patients. The two year freedom from TLR in patch angioplasty cases was also statistically significantly higher than in primary closure cases (98.6% vs. 92.9%; p = .003). During follow up, seven limbs required major amputation and 40 patients died. There was no statistically significant difference in limb salvage and survival between the two groups after PSM.
This is the first report to show that patch angioplasty may decrease re-stenosis and target lesion revascularisation of CFA TEA lesions.
A multicentre retrospective observational study was performed at 34 Japanese centres. Comparisons were made between patients undergoing CFA TEA with or without patch angioplasty after propensity score matching (PSM). The primary endpoints were primary patency and freedom from target lesion revascularisation (TLR) of the TEA lesion. The secondary endpoints were hospital outcomes, limb salvage, and overall survival.
Between 2018 and 2020, 428 TEA procedures (237 with patch angioplasty and 191 with primary closure) were performed. PSM extracted 151 pairs with no significant intergroup differences in baseline characteristics. Peri-operative death and complications occurred in 0.7% vs. 1.3% (p = 1.0) and 6.0% vs. 6.6% (p = 1.0), respectively. The follow up rate was 96% over a median follow up of 14.9 months (interquartile range 8.3, 24.3). Loss of primary patency occurred in 18 patients. The two year primary patency of patch angioplasty cases was statistically significantly higher than that of primary closure cases (97.0% vs. 89.9%; p = .021). TLR was performed in 14 patients. The two year freedom from TLR in patch angioplasty cases was also statistically significantly higher than in primary closure cases (98.6% vs. 92.9%; p = .003). During follow up, seven limbs required major amputation and 40 patients died. There was no statistically significant difference in limb salvage and survival between the two groups after PSM.
This is the first report to show that patch angioplasty may decrease re-stenosis and target lesion revascularisation of CFA TEA lesions.
摘要：
目的：外科血栓内膜切除术（TEA）是治疗股总动脉（CFA）闭塞性病变的标准方法。然而,关于CFATEA中是否需要补片血管成形术的知识有限。这项研究的目的是比较CFATEA伴或不伴补片血管成形术的围手术期和两年结果。
方法：在34个日本中心进行了一项多中心回顾性观察性研究。在倾向评分匹配（PSM）后，对接受CFATEA伴或不伴补片血管成形术的患者进行了比较。主要终点是原发性通畅性和无TEA病变的靶病变血运重建（TLR）。次要终点是医院结果，肢体抢救,和总体生存率。
结果：在2018年至2020年之间，进行了428例TEA手术（237例采用补片血管成形术，191例采用初次闭合）。PSM提取了151对，基线特征没有显着组间差异。围手术期死亡和并发症发生率为0.7%vs.1.3%(p=1.0)和6.0%与6.6%(p=1.0)，分别。随访率为96%，中位随访时间为14.9个月（四分位距8.3，24.3）。18例患者发生原发性通畅性丧失。补片血管成形术病例的两年一次通畅率在统计学上显着高于一次闭合病例（97.0％vs.89.9%；p=.021）。14例患者进行了TLR。在补片血管成形术病例中，两年无TLR的发生率在统计学上也显着高于初次闭合病例（98.6％vs.92.9%；p=0.003）。随访期间,七肢需要大截肢，40名患者死亡。PSM后两组患者的保肢率和生存率差异无统计学意义。
结论：这是首次报告显示补片血管成形术可减少CFATEA病变的再狭窄和靶病变血运重建。
方法：在34个日本中心进行了一项多中心回顾性观察性研究。在倾向评分匹配（PSM）后，对接受CFATEA伴或不伴补片血管成形术的患者进行了比较。主要终点是原发性通畅性和无TEA病变的靶病变血运重建（TLR）。次要终点是医院结果，肢体抢救,和总体生存率。
结果：在2018年至2020年之间，进行了428例TEA手术（237例采用补片血管成形术，191例采用初次闭合）。PSM提取了151对，基线特征没有显着组间差异。围手术期死亡和并发症发生率为0.7%vs.1.3%(p=1.0)和6.0%与6.6%(p=1.0)，分别。随访率为96%，中位随访时间为14.9个月（四分位距8.3，24.3）。18例患者发生原发性通畅性丧失。补片血管成形术病例的两年一次通畅率在统计学上显着高于一次闭合病例（97.0％vs.89.9%；p=.021）。14例患者进行了TLR。在补片血管成形术病例中，两年无TLR的发生率在统计学上也显着高于初次闭合病例（98.6％vs.92.9%；p=0.003）。随访期间,七肢需要大截肢，40名患者死亡。PSM后两组患者的保肢率和生存率差异无统计学意义。
结论：这是首次报告显示补片血管成形术可减少CFATEA病变的再狭窄和靶病变血运重建。
