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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 26, No 1, January/February 2015
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37
80% of TASC II A and B lesions received stents and 76% of
TASC II C and D lesions received bypasses. These figures are in
keeping with those reported in previous studies.
9,18,19
There is evidence that shorter lesions do well with angioplasty/
stent, while longer lesions have significantly lower patency rates.
9
The latest TASC II recommendations include an endovascular
approach for shorter lesions and a bypass for longer lesions.
20
We
followed this principle in our practice. Our study design is similar
to that of Malas
et al
.
9
and Linnakoski
et al
.
21
and the outcomes
are comparable. Notwithstanding we support the concept that an
endovascular-first approach may be advisable in the elderly and
in patients with significant co-morbidity.
22,23
Conclusion
Bearing in mind that this was a retrospective study, in the short
term, stenting is a viable option to treat femoral artery occlusive
disease. It is less invasive and equally effective compared to
bypass surgery, especially in the elderly and in patients with high
cardiovascular risk factors. One-year outcome was comparable
in both groups with regard to mortality rate, stent or graft
patency and limb salvage rates. There is a definite need for long-
term follow up and a randomised, controlled trial to validate
this.
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