A 70-year-old diabetic man with a history of smoking presents with rest pain and a non-healing ulcer on the right big toe. Ankle-brachial pressure index (ABPI) is 0.35 on the right. Angiography shows a long-segment occlusion of the right superficial femoral artery (SFA) and tibial vessel disease. TASC classification would categorise a long-segment SFA occlusion (>15 cm) with tibial disease as:
- A TASC A — amenable to endovascular treatment
- B TASC D — surgical revascularisation recommended ✓
- C TASC B — endovascular preferred
- D TASC C — surgery preferred, endovascular an option
Correct answer: B. TASC D — surgical revascularisation recommended
Explanation
TASC II classification of femoropopliteal lesions: TASC A = single short (<10 cm) stenosis; TASC B = single stenosis or occlusion ≤15 cm; TASC C = multiple stenoses/occlusions or recurrent lesions; TASC D = complete common femoral or SFA occlusion >20 cm involving the popliteal, or complete popliteal and proximal trifurcation occlusion. Long-segment SFA occlusion >15 cm with tibial involvement falls into TASC D, where surgery (femoral-popliteal or femoral-distal bypass) is recommended over endovascular therapy.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.