<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1646-706X</journal-id>
<journal-title><![CDATA[Angiologia e Cirurgia Vascular]]></journal-title>
<abbrev-journal-title><![CDATA[Angiol Cir Vasc]]></abbrev-journal-title>
<issn>1646-706X</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Angiologia e Cirurgia Vascular]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1646-706X2025000400157</article-id>
<article-id pub-id-type="doi">10.48750/acv663</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[The impact of subintimal lesion crossing on femoro-popliteal endovascular treatment outcomes]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Araújo]]></surname>
<given-names><![CDATA[Gonçalo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Correia]]></surname>
<given-names><![CDATA[Ricardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fidalgo]]></surname>
<given-names><![CDATA[Helena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cardoso]]></surname>
<given-names><![CDATA[Joana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Figueiredo]]></surname>
<given-names><![CDATA[Adriana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tavares]]></surname>
<given-names><![CDATA[Carolina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gueifão]]></surname>
<given-names><![CDATA[Inês]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[Maria Emília]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Unidade local de Saúde de São José Hospital de Santa Marta Department of Angiology and Vascular Surgery]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<volume>21</volume>
<numero>4</numero>
<fpage>157</fpage>
<lpage>162</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S1646-706X2025000400157&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S1646-706X2025000400157&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S1646-706X2025000400157&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Subintimal angioplasty is an endovascular technique used to recanalize occluded segments in the arterial bed that cannot be crossed via an intra-luminal path. However, there is still limited data regarding the clinical outcome of subintimal angioplasty. The aim of this study is to evaluate the impact of subintimal angioplasty in femoro-popliteal lesions.  Methods: This is a retrospective, single-centre, comparative study. From January 2023 to February 2025, all patients with chronic lower limb ischemia due to femoro-popliteal arterial lesions who underwent endovascular treatment as a first revascularisation procedure were considered. Patients were grouped according to the cross-lesion pathway: the subintimal cross-lesion group (S group) and the intra-luminal cross-lesion group (L group). Both groups were compared with respect to the atherosclerotic disease pattern, and the primary endpoints were the rates of reintervention and amputation.  Results: The study included 95 patients, of whom 10% (n = 9) presented with intermittent claudication and 90% (n = 85) with chronic limb-threatening ischaemia. The median follow-up time was nine months. The S group included 30% (n = 28) of the patients and L group included 70% (n = 67). The median femoro-popliteal GLASS classification was 4 in both groups, but this GLASS stage was more common in S group (p = 0.004). Severe calcification (p &lt; 0.001) and bailout stenting (p &lt; 0.001) were more common in the S group. Regarding the primary endpoints, no statistically significant differences were found between groups in rates of reintervention (p = 0.95) and amputation (p = 0.26) at 12 months of follow-up.  Conclusion: Our results suggest that the clinical outcomes of subintimal angioplasty are similar to those of intra-luminal angioplasty, with comparable limb outcomes in patients with femoro-popliteal lesions. These findings may support adopting a lower threshold for subintimal crossing in calcified and complex lesions, as it can achieve good results with comparable outcomes to the intra-luminal angioplasty.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Endovascular]]></kwd>
<kwd lng="en"><![CDATA[subintimal]]></kwd>
<kwd lng="en"><![CDATA[femoro-popliteal]]></kwd>
<kwd lng="en"><![CDATA[calcification]]></kwd>
<kwd lng="en"><![CDATA[reintervention]]></kwd>
<kwd lng="en"><![CDATA[amputation]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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