Endovascular interventions for long occlusive disease of the superficial femoral artery in critical limb ischemia

Background
The real challenges for the treatment of femoropopliteal disease are long and chronic total occlusions. These lesions continue to represent a major challenge for currently available endovascular approaches. The aim of this study was to evaluate the outcomes of an endovascular intervention for Transatlantic Intersociety Consensus (TASC)-II C and D femoropopliteal disease.
Patients and methods
Sixty-four patients, including 16 patients with TASC-C and 48 patients with TASC-D lesions, underwent an endovascular intervention for femoropopliteal lesions between January 2014 and December 2014. Patients’ demographics and preprocedure and postprocedure ankle brachial indices were analyzed. The outcomes of our study were primary patency, periprocedural complications, and limb salvage.
Results
Our cohort included 41 (64%) men and 23 (36%) women. Twenty-one (33%) patients had rest pain and 43 (67%) patients presented with tissue loss. All patients underwent initial balloon angioplasty of occluded arterial segments, with a technical success achieved in 58 (91%) patients. Nitinol stents were used in 15 (26%) patients. Eight (14%) patients developed periprocedural complications. Primary patency rates were 96.6, 89.7, 80.9, and 62.1% at 1, 3, 6, and 12 months, respectively. Univariate analysis of sex, risk factors, Rutherford staging, and TASC-II lesion could not find any statistically significant effect on the 1-year primary patency rate in the current study.
Conclusion
Our experience showed the benefficial results of an endovascular intervention for TASC-II C and D lesions with good acceptable early-term and medium-term patency and limb salvage rates.