Subintimal angioplasty of chronic total superficial femoral artery occlusions in critical lower limb ischemia patients: the single center experience

Abstract

Objective The aim of this article was to report our results of subintimal angioplasty (SIA) of long superficial femoral artery (SFA) occlusions and try to appreciate factors that affect patency following this type of intervention in critical lower limb ischemia (CLI) patients. Patients and methods The current series was conducted prospectively over a 1-year period. Forty cases, 40 limbs (mean age = 65.8 years old) with long SFA occlusion (>15 cm) and patent popliteal artery continuous with at least one leg artery runoff were included. Exclusion criteria were: renal impairment, nonatherosclerotic occlusions (thrombosis, dissection, or compression), short SFA occlusions ( Results Results were considered successful in 34 (85%) patients and failure was noticed in six (15%) cases. At the end of the first follow-up year, the primary patency rate was 75% and the salvage rate was 87.5%. The 1-year patency rate was higher in TASC C patients (85.7%) in comparison with TASC D cases (69.2%). The patency rate was 50% or less with one patent leg artery and 80% or more with two or three patent leg arteries. Conclusion SIA is a good alternative for recanalization of chronic long SFA total occlusions in CLI patients with accep[table 1]-year patency rates. Number of patent leg arteries is an important determinant of durable procedures.