Current Efficacy Of Surgical And Catheter-based Revascularization For Isolated Popliteal Arteriosclerotic Disease

Objective: Simple popliteal artery stenosis or occlusion was rare in clinic,and there were few reports in the literature.The literature had traditionally combined the popliteal artery with the femoral vessels..However,unlike the superficial femoral artery,the popliteal artery had its embryological origined from the sciatic system.Anatomically,.the popliteal artery was subjected to significant biomechanical forces that result from repetitive flexion of the knee.Therefore,the durability of angioplasty in this region was extremely variable.With the updated of the interventional material and the progressed of technology,there has been a marked paradigm shift in the treatment of symptomatic popliteal disease with a shift from open to endoluminal therapy.Trials evaluating surgical relative to endovascular treatment were uncommon;therefore,there remained a lack of evidence-based medicine to support either approach having a clear advantage over the other.key Trials addressing this deficit in evidence are now ongoing in Europe and the United States,and the results are coming soon.The purpose of this article was to evaluate the clinical effect of open and endovascular interventions(ENDO)on patients suffering from the pure popliteal arteriosclerotic disease.Method: A database of patients undergoing open(endarterectomy/synthetic patch aortoplasty,49 cases,53 lower limbs)and endoluminal intervention(balloon dilatation,58 cases,65 lower limbs)for isolated popliteal lesions between 2012.9 and 2016.6 was retrospectively queried.Analyses were performed using SPSS Software(version 22.0),measurement datas are presented as means ± standard deviation,the comparison between groups was tested by independent samplet,and the matching sample t test was adopted in the group,and c2 test was used for the counting data.The threshold of statistical significance was p<0.05.Result: The average follow-up was 18.7±3.6 months.In both groups,ABI had a significant increase in the postoperative and ABI was statistically significant,The amputation rate of open group was 16.33 percent in 12 months after operation,and the ENDO group was 3.23 percent,the hospitalization time was 13.77 days and 6.14 days for interventional treatment group.,The incidence rate of incision complications was 20.75%,and the incidence of complications was 6.15% in ENDO group,two groups had significant difference(P<0.05).And there was no significant difference in the incidence of systemic complications.There was no significant difference between the two groups of patients in 1st,3th and 6th month primary patency,the 12 th primary patency of ENDO was 66.13% and OPEN was 87.76%(P<0.05).The second patency of ENDO and OPEN were 91.94%,89.80%;there were no statistically significant.Conclusion:(1)OPEN and ENDO were both effective in treatment of isolated popliteal arteriosclerotic disease,interventional therapy could be regarded as the first strategy in treatment of isolated popliteal stenosis or occlusion disease.(2)In terms of short-term patency,the surgical treatment was superior to the interventional treatment,more centers and long term follow-up were necessary.