Impact of Tibial Runoff on Outcomes of Endovascular Treatment for Femoropopliteal Atherosclerotic Lesions

Objectives: The aim of this study is to investigate the impact of tibial runoff on outcomes of femoropopliteal interventions for atherosclerotic lesions. Methods: A retrospective review of 243 endovascular procedures for femoropopliteal atherosclerotic lesions on 243 limbs of 197 patients was performed. Results: The distribution rates of good tibial runoff (runoff score <7) and poor tibial runoff (runoff score >= 7) were 37.0% and 63.0%, respectively. In the poor tibial runoff group, the patients were older (P = .019), and the proportion of male was lower (P = .014). There was a significantly higher proportion of rest pain or tissue loss (P < .001), and the prevalence of stroke (P = .031) and renal insufficiency (P = .005) was significantly higher in the poor runoff group. After femoropopliteal intervention, the amputation-free survival (P = .03) and freedom from ischemia (P = .003) were significantly lower in the poor runoff group. The interventions targeting below-the-knee (BTK) lesions performed concomitantly for critical limb ischemia or tissue loss with poor tibial runoff did not show a significant advantage in terms of freedom from ischemia; however, minor trends of longer lasting freedom from ischemia were observed when BTK intervention was combined. Conclusion: The patients with poor runoff showed significantly lower amputation-free survival and freedom from ischemia. In poor tibial runoff limbs with critical limb ischemia or tissue loss, BTK intervention did not demonstrate additional significant beneficial outcomes; however, there was a minor trend of longer lasting freedom from ischemia after concomitant BTK intervention.