Endovascular intervention in flush superficial femoral artery occlusive disease: challenges and outcome

Ghoneim, Baker; Younis, Sayed; Elmahdy, Hossam; Elwan, Hussein; Khairy, Hussein

doi:10.23736/s1824-4777.18.01368-2

Cited by 1 publication

(1 citation statement)

References 28 publications

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“…Our patency rates are higher than the primary (57.5%) and secondary (64%) patency rates reported in Ghoneim et al study, which included 43 patients presenting with critical limb ischemia and flush SFA occlusion. 16 Their lower patency and limb salvage rates (76.7%) may be attributed to the higher prevalence of patients with tissue loss (84%) compared to 69.4% in our study. In their analysis to determine factors affecting patency and limb salvage, their limb salvage rates were clearly better in patients presenting with rest pain compared to those with tissue loss (100% vs 76%, respectively).…”

Section: Discussioncontrasting

confidence: 47%

Duplex-Guided Ipsilateral Antegrade Approach for Flush Superficial Femoral Artery Occlusion

Saleh

Ali

Gamal

et al. 2023

Vasc Endovascular Surg

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Objective Recanalization of flush ostial superficial femoral artery (SFA) occlusion is a very challenging procedure. Using the ipsilateral antegrade approach in such lesions has some difficulties. This study aimed to assess the feasibility, efficacy, and outcomes of duplex-guided ipsilateral antegrade access for endovascular treatment of atherosclerotic flush occlusion of the SFA. Methods This is a prospective two-center study that included chronic lower extremity ischemia patients with flush occlusion of SFA who underwent duplex-guided ipsilateral antegrade endovascular revascularization due to unfeasible contralateral femoral approach. Flush occlusions were preoperatively documented by duplex ultrasound and computed tomography angiography in all patients. The outcome measures were technical success, patency rates, perioperative morbidity and mortality, limb salvage, and amputation free survival rates. Results Between April 2019 and March 2021, 49 patients were enrolled in the current study with a mean age of 63.7 ± 5.7 years. Diabetes was the most common risk factor and was found in 40 (81.6%) patients. Associated popliteal lesions were found in seven (14.3%) patients, while 10 (20.4%) patients had combined tibial disease. Selective stenting was done in nine (18.4%) patients. Technical success was achieved in 43 (87.8%) patients. All failures were due to inability to cross the lesion rather than failure to access the common femoral artery. All complications were minor and occurred in seven (14.3%) patients. Primary, assisted primary, and secondary patency rates were 63.9% ± 7.1%, 82.8% ± 5.6%, and 93.5% ± 3.7% at 12 months, respectively. The overall 12-month limb salvage and amputation free survival rates were 91.8% and 83.3% ± 5.4%, respectively. Conclusion Duplex-guided ipsilateral antegrade femoral access is a feasible, safe, and effective endovascular treatment option for flush SFA occlusion when contralateral femoral access is not possible.

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Section: Discussioncontrasting

confidence: 47%