Abstract
Remote SFA endarterectomy is a hybrid technique that affords lower limb revascularization without the patient having to undergo a bypass operation especially when the vessels are small (women, Asian decent) and the run off poor. The procedure allows for a larger calibre SFA lumen to be gained, which cannot be obtained from a repeat endovascular procedure for in stent occlusion. Remote endarterectomy down to infrageniculate level has not been previously reported. We describe a modified version of remote endarterectomy with use of a subintimal wire to help remove an occluded SFA stent in the setting of a calcified SFA. This hybrid technique is ideal for flush SFA occlusions.
Highlights
Remote superficial femoral artery (SFA) endarterectomy is a hybrid treatment option for long flush SFA occlusions
The procedure allows for a larger calibre SFA lumen to be gained, which cannot be obtained from a repeat endovascular procedure for in stent occlusion
We describe a modified version of remote endarterectomy with use of a subintimal wire to help remove an occluded SFA stent in the setting of a calcified SFA
Summary
Remote superficial femoral artery (SFA) endarterectomy is a hybrid treatment option for long flush SFA occlusions. We describe a modified version of this technique to remove an occluded SFA stent in a patient who presented with a non-healing forefoot amputation wound and rest pain with severe multi-level disease and single vessel peroneal runoff (Figure 1)
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