A 55-year-old diabetic man presents with rest pain in the right foot and a non-healing plantar ulcer. ABPI is 0.42 on the right. CTA shows a long superficial femoral artery (SFA) occlusion (TASC II Class C) and a patent popliteal artery. The TASC II classification recommends for Class C femoropopliteal lesions:
- A Endovascular treatment is the treatment of choice
- B Conservative management and supervised exercise
- C Surgery is preferred, but endovascular is acceptable in high-risk surgical patients ✓
- D Primary amputation
Correct answer: C. Surgery is preferred, but endovascular is acceptable in high-risk surgical patients
Explanation
TASC II (Trans-Atlantic Inter-Society Consensus) classification: Class A = endovascular treatment of choice; Class B = endovascular preferred; Class C = surgery preferred, endovascular acceptable in high operative risk; Class D = surgery is the treatment of choice. For a Class C femoropopliteal lesion (long occlusion 15–25 cm or multiple stenoses), surgical bypass (fem-pop bypass with autologous vein) is preferred to achieve durable revascularisation, though endovascular is offered when surgical risk is prohibitive.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.