Guidelines adherence or chronic total occlusion recanalization of the superficial femoral artery with a stentless approach: The next frontier?

• 发表时间: 2019
• 来源期刊: SAGE Open Med Case Rep
• DOI: 10.1177/2050313X18823445
• PMID: 30719307
• 文章类型: Case Reports
• 作者列表: Rammos C,Radecke T,Lortz J,Steinmetz M,Rassaf T

关键词: Superficial femoral artery; atherectomy; chronic total occlusion; drug-coated balloon

Abstract

In patients with intermittent claudication and long chronic total occlusions of the superficial femoral artery, a primary surgical bypass or stenting is recommended. However, due to the invasive nature, high complication rates and patient-related comorbidities, surgery is currently not the preferred method and full lesion stenting for long chronic total occlusions has the obvious consequences of permanent metallic implants. We report a case of a patient with a long chronic total occlusion of the superficial femoral artery with intermittent claudication. Endorsing an endovascular-first strategy, he was treated via an antegrade and retrograde approach with a complete recanalization and a stentless treatment with rotational atherectomy and drug-coated balloons. We believe this is a feasible endovascular strategy for the treatment of long chronic total occlusions of the superficial femoral artery for patients refusing open surgery. Further investigations are needed to evaluate long-term clinical outcomes of these novel techniques.