New research conducted by Johns Hopkins University School of Medicine, Baltimore, MD, reported online in the Journal of Vascular Surgery, suggests that people who undergo minimally invasive placement of stents to open clogged leg arteries are significantly less likely than those who have conventional bypass surgery to need a second treatment for the condition within two years.
While bypass surgery remains the gold standard for treating symptoms of peripheral artery disease (PAD), the scientists believe that further research will confirm the advantage their study shows for the stents.
They say that their study also found that both treatments were equally successful in restoring healthy blood circulation to the legs. But threading a stent through an artery through access in the groin and into the blocked leg vessel to create a wider path for blood requires no general anesthesia and is typically associated with shorter hospital stays and recovery times than open bypass.
PAD is a common circulatory problem in which narrowed arteries reduce blood flow to the limbs, and its most notable symptom is leg pain when walking. Once the pain is chronic, even without walking, doctors consider manually bypassing the blockages. In contrast to minimally invasive stenting, a so-called femoral-popliteal bypass requires a large incision to open the leg, and the surgical attachment of a piece of vein or a synthetic tube above and below the blockage to reroute blood flow.
The Hopkins study was conducted by analyzing records from 104 patients with PAD who either got a stent or a bypass operation at Johns Hopkins Bayview Medical Center between September 2005 and September 2010. Patients who received stents had a 31 percent risk of needing another procedure to restore blood flow within 24 months, while those who received a bypass had a 54 percent chance of needing another intervention. The researchers found that women were twice as likely as men to need a second operation.