{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:13:58Z","timestamp":1790392438183,"version":"4.1.0"},"reference-count":21,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T00:00:00Z","timestamp":1715126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Lower extremity arterial disease is one of the most prevalent manifestations of atherosclerosis. The results from numerous studies regarding the best revascularization method of an occluded superficial femoral artery have been conflicting. The aim of this study was to compare the patency of transvenous endovascular with open femoropopliteal bypass, both with vein and prosthetic grafts. To our knowledge, a direct patency comparison between transvenous endovascular and open femoropopliteal bypass has not been published. This could help elucidate which method is preferable and in which cases. Materials and Methods: Patients with complex TASC-C and D SFA lesions were offered endovascular transvenous or open bypass. A total of 384 consecutive patients with PAD requiring surgical treatment were evaluated for inclusion in this study. Three-year follow-up data were collected for 52 endovascular procedures, 80 prosthetic grafts, and 44 venous bypass surgeries. Bypass patency was investigated by Duplex US every 6 months. Kaplan\u2013Meier plots were used to analyze primary, primary-assisted, and secondary patency for endovascular transvenous, autovenous, and prosthetic bypasses. Results: Primary, primary-assisted, and secondary patency in venous group at 3 years was 70.5%, 77.3%, and 77.3%, respectively. In the endovascular transvenous group, primary, primary-assisted, and secondary patency at 3 years was 46.2%, 69.2%, and 76.9%, respectively. The lowest patency rates at 3 years were noted in the prosthetic graft group with 22.5% primary, 26.6% primary-assisted, and 28.2% secondary patency. Conclusions: The saphenous vein is the best graft to perform in above-the-knee femoropopliteal bypass. Transvenous endovascular bypass is a viable option with comparable primary-assisted and secondary patency. Primary patency is substantially lower for endovascular transvenous compared to venous bypass. Patients treated with endovascular transvenous bypass will require a significant number of secondary procedures to provide optimal patency. Prosthetic grafts should only be used if no other option for bypass is available.<\/jats:p>","DOI":"10.3390\/medicina60050777","type":"journal-article","created":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T03:23:19Z","timestamp":1715138599000},"page":"777","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Endovascular Transvenous versus Open Femoropopliteal Bypass"],"prefix":"10.3390","volume":"60","author":[{"given":"Roberts","family":"Rumba","sequence":"first","affiliation":[{"name":"Vascular Surgery Department, Pauls Stradins Clinical University Hospital, 1002 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dainis","family":"Krievins","sequence":"additional","affiliation":[{"name":"Vascular Surgery Department, Pauls Stradins Clinical University Hospital, 1002 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalija","family":"Ezite","sequence":"additional","affiliation":[{"name":"Diagnostic Radiology, Diagnostic and Interventional Radiology Centre, Pauls Stradins Clinical University Hospital, 1002 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2344-2867","authenticated-orcid":false,"given":"Aigars","family":"Lacis","sequence":"additional","affiliation":[{"name":"Vascular Surgery Department, Pauls Stradins Clinical University Hospital, 1002 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludovic","family":"Mouttet","sequence":"additional","affiliation":[{"name":"Department of Surgical and Interventional Sciences, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3G 2M1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anda L.","family":"Vavere","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Latvia, 1004 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher K.","family":"Zarins","sequence":"additional","affiliation":[{"name":"Department of Surgery, Stanford University Medical Center, Stanford, CA 95305, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E171","DOI":"10.1161\/CIR.0000000000001005","article-title":"Lower Extremity Peripheral Artery Disease: Contemporary Epidemiology, Management Gaps, and Future Directions: A Scientific Statement from the American Heart Association","volume":"144","author":"Criqui","year":"2021","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"101082","DOI":"10.1016\/j.cpcardiol.2021.101082","article-title":"Peripheral Artery Disease: A Comprehensive Updated Review","volume":"47","author":"Shamaki","year":"2022","journal-title":"Curr. 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