Recanalization of flush and stent occlusions in the superficial femoral artery under real-time ultrasound guidance

Abstract

Objectives. To evaluate the usefulness of real-time ultrasound (US) guidance in cannulating superficial femoral artery (SFA)flush and SFA in-stent occlusions. Methods. A total of 37 patients were treated under real-time US guidance, among whom 22 were treated for flush and 15 for stent occlusions. In all cases, the axial and longitudinal US images were examined to confirm the guidewire's location. Results. All attempts to cannulate lesions were successful. The initial and adjunctive procedures were conventional balloon angioplasty, catheter-directed thrombolysis with urokinase and conventional balloon angioplasty, stenting, stent grafting, drug-coated balloon (DCB) angioplasty, and rotational atherectomy and DCB angioplasty in 8, 4, 5, 2, 1, and 1 cases of the 22 flush occlusions, respectively, and in 9, 1, 0, 0, 2, and 0 cases of the 15 stent occlusions, respectively. No complications associated with the procedures occurred in any case. Conclusion. Real-time US guidance can be used for precise and effective cannulation of flush occlusions of SFA or totally occluded SFAin-stents with reduced extra-radiation exposure to the operator and patient.