E-Abstract

JACC

Lots of interesting abstracts and cases were submitted for TCTAP 2025. Below are the accepted ones after a thorough review by our official reviewers. Don¡¯t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-083

A Comparative Study on Long Term Outcomes of Bypass Surgery Versus Endovascular Therapy in Patients With Superficial Femoral Artery Occlusive Disease

By Md Moynul Islam, Naresh Chandra Mandal, Abul Hasan Muhammad Bashar, Shaila Sharmin

Presenter

Md Moynul Islam

Authors

Md Moynul Islam1, Naresh Chandra Mandal1, Abul Hasan Muhammad Bashar1, Shaila Sharmin2

Affiliation

National Institute of Cardiovascular Diseases, Bangladesh1, Combined Military Hospital, Bangladesh2
View Study Report
TCTAP A-083
Surgical Therapy (Endovascular)

A Comparative Study on Long Term Outcomes of Bypass Surgery Versus Endovascular Therapy in Patients With Superficial Femoral Artery Occlusive Disease

Md Moynul Islam1, Naresh Chandra Mandal1, Abul Hasan Muhammad Bashar1, Shaila Sharmin2

National Institute of Cardiovascular Diseases, Bangladesh1, Combined Military Hospital, Bangladesh2

Background

Bypass surgery offers higher long-term patency rates and durability. On the other hand, endovascular therapy presents a less invasive alternative with quicker recovery. Both methods effectively restore blood flow, but careful patient selection is essential to ensure optimal outcomes and to determine the most suitable treatment approach for eachindividual cases. The aim of this study was to assess outcome of bypass surgery and endovascular therapy in patients with superficial femoral artery occlusive diseases.

Methods

 It was a randomized clinical trial carried out Department of Vascular Surgery, National institute of Cardiovascular Diseases Hospital (NICVD), Dhaka Bangladesh. Total of 50 patients with SFA occlusive disease being operated, 30 patients underwent bypass surgery and 20 patients underwent endovascular therapy.. 

Results

This study shows the average age 56.63¡¾6.87 years in Bypass surgery (Group A) and 54.25¡¾2.5 years in Endovascular therapy (Group B). The most commonly affected age group was 51–60 years between two groups. Most of patients in both groups were males (76.7% in group A and 70% in group B). Hypertension was the most common risk factors in both groups (60% group A and 55% group B). 36.7% were diabetics in group A and 40% in group B. Ischemic heart diseases were 36.7% in group A and 45% in group B. Current smoking was found in both groups in this study with a percentage of 60% in group A and 50% in group B. Study shows endovascular therapy had higher preoperative mean ABI than the bypass group (0.59 vs 0.56; P =0.189), the postoperative mean ABI was the same in both groups (0.88; P= 0.434). There was significant and similar improvement in mean ABI for both Endovascular therapy and bypass groups postoperatively (0.32 vs 0.28; P = 0.344). After 1 year of intervention, 15 (46.7%) cases developed significant stenosis in group A and 6 (30%) cases developed significant stenosis in groupB. It was observed that complications occurred in 4 cases in the bypass group (13.3%) and in 4 cases in the Endovascular therapy group (20%). 

Conclusion

The present study showed that there was no statistical difference between the bypass and EVT groups with regard to complication, frequency of revascularization and primary/secondary patency. However, the treatment choice remains largely biased by the treating physician¡¯s comfort and experience and not necessarily based on the durability of treatment method.