Journal de médecine vasculaire et de chirurgie

Abstrait

The Association between Infrageniculate Run-off Score and Selection of Revascularization Method in Patients with Critical Limb Ischemia and Long Segment Lesion of Popliteal Artery

Aina Kratovska*, Sanita Ponomarjova, Lilian Tzivian, Patricija Ivanova

Background: Quantitative infrageniculate run-off scoring is not highlighted by guidelines of Critical Limb Ischemia (CLI) management. Although not strictly declared, infrageniculate run-off plays an important role in revascularization method (open versus endovascular) selection.

Aim: The aim of this study was to test the infrageniculate run-off scoring system proposed by authors and its association with the selection of the revascularization method in CLI patients with long femoropopliteal lesions involving popliteal artery P1-P2 segment.

Materials and methods: Forty-seven patients with Infrageniculate Bypass Surgery (IGBS) and 36 with Endovascular Therapy (EVT) of long femoropopliteal segment were enrolled into single centre case-control study. Long atherosclerotic lesion of popliteal artery P1-P2 segment was mandatory inclusion criteria. Infrageniculate run-off scoring system proposed by authors (total occlusion=0 point, intact=22) was used to analyze infrageniculate artery status. Age, gender, place of patients’ residence, Rutherford category, femoropopliteal lesion TASC II type, infrageniculate run-off score and the association of variables with revascularization method choice were analyzed.

Results: In IGBS and EVT group mean total infrageniculate run-off score was 15.36 ± 3.99 and 9.51 ± 5.73, respectively. Multiple logistic regression analysis showed that infrageniculate run-off score and femoropopliteal lesion TASCII type has a strong association with revascularization method choice (p<0.001, OR 0.491, 95% CI:0.337-0.714 and p<0.001, OR 0.091, 95% CI:0.026-0.322 respectively).

Conclusion: Study results show that infrageniculate run-off score is a strong predictor of revascularization modality choice in patients with CLI and long femoropopliteal lesion. An authors proposed scoring system was successfully tested for quantitative preoperative assessment of infrageniculate run-off.