Abstract No. 229: Stenting of the Superficial Femoral Artery: One Year Outcomes for Patients with Chronic Limb Ischemia and Claudication

Purpose: To report a new technique to reenter the common femoral artery (CFA) true lumen after retrograde recanalization of a superficial femoral artery (SFA) with flush ostial occlusion. Technique: The technique is demonstrated in a 76-year-old woman with critical limb ischemia previously submitted to several surgical revascularizations. A duplex ultrasound showed flush ostial occlusion of the SFA and patency of the anterior tibial artery at the ankle as the sole outflow vessel. After unsuccessful antegrade attempts to recanalize the SFA, a retrograde guidewire was advanced subintimally up to the CFA, without gaining reentry. A balloon catheter was inflated in the subintimal plane across the SFA ostial occlusion. Antegrade access to the distal CFA was achieved with a 20-G needle, which was used to puncture the balloon. A guidewire was advanced into the balloon and pushed forward while the collapsed balloon was pulled back to the mid SFA. The antegrade guidewire was externalized through a retrograde catheter, which was pushed in the CFA true lumen. A retrograde guidewire was advanced and externalized through the femoral sheath, establishing a flossing wire. The procedure was completed in antegrade fashion. Conclusion: The FORLEE technique is a cost-effective option to gain the CFA true lumen after subintimal retrograde recanalization of an ostial SFA occlusion.

Download Full-text

LEA 2. Four-Year-Long Outcome With Drug-Coated Balloons for Superficial Femoral Artery Lesions in Patients With Critical Limb Ischemia: Comparison With Conventional Bypass Surgery

Journal of Vascular Surgery ◽

10.1016/j.jvs.2019.08.019 ◽

2019 ◽

Vol 70 (5) ◽

pp. e116

Author(s):

Onur S. Göksel

Keyword(s):

Femoral Artery ◽

Critical Limb Ischemia ◽

Superficial Femoral Artery ◽

Bypass Surgery ◽

Limb Ischemia

Download Full-text

TCTAP A-091 Predictor Analysis of One Year Restenosis After Balloon Angioplasty for Superficial Femoral Artery Lesion Using Intravascular Ultrasound

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2017.03.131 ◽

2017 ◽

Vol 69 (16) ◽

pp. S49

Author(s):

Shunsuke Kakizaki ◽

Amane Kozuki

Keyword(s):

Intravascular Ultrasound ◽

Femoral Artery ◽

Balloon Angioplasty ◽

Superficial Femoral Artery ◽

One Year

Download Full-text

Quality of Life after Balloon Angioplasty versus Stent Implantation in the Superficial Femoral Artery: Findings from a Randomized Controlled Trial

Journal of Endovascular Therapy ◽

10.1177/152660280701400401 ◽

2007 ◽

Vol 14 (4) ◽

pp. 431-437 ◽

Cited By ~ 19

Author(s):

Schila Sabeti ◽

Alfa Czerwenka-Wenkstetten ◽

Petra Dick ◽

Oliver Schlager ◽

Jasmin Amighi ◽

...

Keyword(s):

Quality Of Life ◽

Femoral Artery ◽

Balloon Angioplasty ◽

Superficial Femoral Artery ◽

Stent Implantation ◽

Controlled Trial ◽

Limb Ischemia ◽

Post Intervention ◽

Primary Stenting

Purpose: To investigate whether primary nitinol stenting in the superficial femoral artery (SFA) is beneficial to patients' quality of life (QoL). Methods: One hundred four patients (55 men; mean age 66±19 years) with chronic limb ischemia and SFA disease were randomly assigned to primary stent implantation (n=51) or balloon angioplasty (n=53) with optional stenting for a suboptimal angioplasty result (17 of 53). QoL was measured by the SF-36 questionnaire at baseline and at 3, 6, and 12 months post intervention. Results: QoL was significantly improved post intervention and up to 12 months in both treatment groups. Significant inverse associations were observed between QoL parameters and restenosis. Comparing primary stenting (n=51) versus balloon angioplasty with optional stenting (n=53) by the intention to treat, no significant differences in QoL were observed. Analyses of stented patients (n=68) versus balloon angioplasty (n=36) patients, however, demonstrated significantly improved measures of QoL after stenting. Conclusion: Endovascular revascularization of SFA disease improves QoL, and restenosis negatively affects QoL outcomes. After stent implantation, whether primary or secondary, QoL was significantly ameliorated compared to balloon angioplasty alone. However, it remains to be proven in larger cohorts whether primary stenting yields a QoL benefit compared to balloon angioplasty with optional secondary stenting.

Download Full-text

The deep femoral artery as a inflow source for distal reconstruction

Modern medical technologies ◽

10.34287/mmt.2(41).2019.22 ◽

2019 ◽

Vol 41 part 2 (2) ◽

pp. 35-38

Author(s):

V. I. Rusyn ◽

V. V. Korsak ◽

V. V. Rusyn ◽

F. V. Horlenco ◽

V. M. Dobosh

Keyword(s):

Quality Of Life ◽

Femoral Artery ◽

Limb Ischemia ◽

Deep Femoral Artery ◽

Autologous Vein ◽

Vein Bypass ◽

Profunda Femoris ◽

Chronic Limb Ischemia

of the study. To improve the treatment outcomes of patients with occlusion-stenotic lesions of the femoral-popliteal-tibial segment, long-term results of the profundafemorispopliteal autologous vein bypass surgery have been studied. Material and methods. In the surgical clinic of A. Novak Regional Clinical Hospital during the last 10 years has been performed 300 isolated profundoplasty at chronic limb ischemia. In 16 p atients w ith d eep femoral popliteal autologous vein bypass, a distal segment of arteria profunda femoris was used as the «tidal» artery, which varied from 0,51 to 0,63 in diameter (0,58 cm in average). Results. In the immediate and long-term follow-up period, no thrombosis of profunda femoris popliteal autologous vein shunt was observed in 5 years. The ankle-brachial pressure index after surgery increases almost twice and approaches 0,9 on posterior tabial artery. The mean profunda popliteal collateral index score decreased to 0,301 ± 0,099 in all patients after surgery. If we compare the quality of life after profunda femoris popliteal autologous vein reconstruction, it should be noted that the quality of life in our patients before the operation was 21,8 ± 4,9 points, after the operation − 45,6 ± 4,9 points. Conclusion.Profundafemorispopliteal autologous vein bypass by a length of up to 15 cm provides blood supply to the limb with stenoticocclusive lesions of the femoral-popliteal-tibial segment, with the passage of at least one artery of the leg and the arteries of the pedis. Keywords: chronic limb ischemia; deep femoral artery, prufundoplasty.

Download Full-text

Endovascular Recanalization of Chronic Total Occlusions of the Native Superficial Femoral Artery After Failed Femoropopliteal Bypass in Patients with Critical Limb Ischemia.

10.21203/rs.3.rs-511684/v1 ◽

2021 ◽

Author(s):

Roberto Minici ◽

Michele Ammendola ◽

Marisa Talarico ◽

Maria Luposella ◽

Marco Minici ◽

...

Keyword(s):

Femoral Artery ◽

Critical Limb Ischemia ◽

Superficial Femoral Artery ◽

Limb Ischemia ◽

Secondary Patency ◽

Femoropopliteal Bypass ◽

Technical Success ◽

Clinical Prognosis ◽

Chronic Total Occlusions ◽

Endovascular Recanalization

Abstract Background: The femoropopliteal bypass occlusion in patients with critical limb ischemia and chronic total occlusion of the native superficial femoral artery remains a significant problem, that hardly challenges vascular surgeons and interventional radiologists. Performing a secondary femoropopliteal bypass is still considered the standard of care, although it is associated with a higher complication rate and lower patency rate in comparison with primary bypass. Advanced age, lack of a good great saphenous vein, anastomosis’ pseudoaneurysms and high surgical risks make surgical approach not always suitable. Over the past few years, angioplasty has been commonly used, with the development in endovascular technologies, to treat chronic total occlusions of the native SFA, with a good technical success rate and clinical prognosis. Hence, the idea to recanalize the native SFA chronic total occlusions, in patients with critical limb ischemia (CLI) and femoro-popliteal bypass failure, has been born, limited to those patients unfit for surgery or refusing surgical reconstruction. Data regarding long-term outcomes of this approach in femoro-popliteal bypass failure are limited to few case-series studies.Results: Technical success was achieved in 51 (94.4%) of 54 limbs. Angiographically, 77.8% of the lesions were TASC II category D, while 22.2% TASC II category C. The average length of the native SFA lesions was 26.8 cm. Clinical success, with improved Rutherford classification staging, followed each case of technical success. The median follow-up value was 5.75 years (IQR, 1.5 – 7). By Kaplan-Meier survival analysis, primary patency rates were 61% (±0.07 SE) at 1 year and 46% (±0.07 SE) at 5 years. Secondary patency rates were 93% (±0.04 SE) at 1 year and 61% (±0.07 SE) at 5 years. Limb salvage rates were 94% (±0.03 SE) at 1 year and 88% (±0.05 SE) at 5 years.Conclusions: The endovascular recanalization of chronic total occlusions (CTO) of the native superficial femoral artery (SFA) after failed femoropopliteal bypass is a safe and effective therapeutic option in patients unfit for surgery with critical limb ischemia.

Download Full-text

Acute Limb Ischemia due to a Fractured Superficial Femoral Artery Stent

Marshall Journal of Medicine ◽

10.18590/mjm.2016.vol2.iss4.12 ◽

2016 ◽

Vol 2 (4) ◽

Author(s):

Alaa Gabi ◽

◽

Ahmed Amro ◽

Haytham Aljoudi ◽

Faisal Hayat ◽

...

Keyword(s):

Femoral Artery ◽

Superficial Femoral Artery ◽

Limb Ischemia ◽

Acute Limb Ischemia

Download Full-text

POOR PROGNOSTIC DETERMINANTS FOR PATIENTS UNDERGOING SUPERFICIAL FEMORAL ARTERY ANGIOPLASTY

International Journal of Advanced Research ◽

10.21474/ijar01/12078 ◽

2020 ◽

Vol 8 (11) ◽

pp. 828-831

Author(s):

S. Maruthu Thurai ◽

◽

P. Mohan Raja ◽

M. Murali ◽

◽

...

Keyword(s):

Renal Insufficiency ◽

Femoral Artery ◽

Critical Limb Ischemia ◽

Superficial Femoral Artery ◽

Lower Limb ◽

Prospective Observational Study ◽

Negative Impact ◽

Limb Ischemia ◽

Limb Amputation ◽

The Poor

Introduction: Aim is to study the poor prognostic determinants for patients undergoing superficial femoral artery angioplasty . Material and Methods: It is a Prospective observational study done in fifty patients who has undergone superficial femoral artery angioplasty for lower limb ischemia. Results: 22% had reocclusion of lesion, 10% required reintervention and 8% underwent major limb amputation .These three were considered major negative impact conditions. These were found in majority of patients with renal insufficiency, critical limb ischemia, smoker and drug defaulters. Conclusion: Thus poor prognostic determinants in the study were renal insufficiency, critical limb ischemia , smoker and drug defaulters.

Download Full-text