JET+PCB strategy in the treatment of superficial femoral artery occlusion: a case report

Abstract

Сritical limb ischemia (CLI) is becoming more and more common among patients worldwide. This is a comorbid condition, which is accompanied by chronic pain, sometimes trophic ulcers and gangrene, as well as a decrease in the quality of life. Despite the chronic nature of ischemia, the absence of treatment is accompanied by a high incidence of limb amputation and death. Patients with lower limb atherosclerosis had the higher risk of cardiovascular events and death. This publication proposes to consider minimally invasive interventional arterial revascularization in a 63-year-old patient with intermittent claudication, stage III critical limb ischemia, with a history of bilateral superficial femoral artery (SFA) stenting. Control lower limb angiography showed bilateral SFA occlusion and thrombosis. Taking into account the restenosis of the previously implanted stent, JET+PCB strategy was considered: first stage — rotational atherectomy followed by SFA angioplasty with a drug-eluting balloon catheter. The correct choice of minimally invasive surgery method in combination with non-pharmacological (smoking cessation, training walking) and pharmacological methods made it possible to restore viability and preserve the lower limb without negative consequences for the patient's health.