Evaluation of long superficial femoral artery stenting in a critically ischemic limb

Aim The aim of the study was to evaluate 1-year efficacy and integrity of long stents implanted in the superficial femoral artery (SFA) in a critically ischemic limb. Patients and methods A prospective study was carried out between July 2012 and September 2014 on 25 patients (19 men and six women, mean age 58 years, range 52-65 years) suffering from critical limb ischemia (Rutherford classification 4 or 5) caused by a long SFA lesion who underwent stenting of the targeted segment at the 6th October Insurance Hospital (Dokki, Cairo, Egypt). Patients were scheduled to receive a single stent and were evaluated for 1 year. An overall 60% (15 patients) had occluded segments and 40% (10 patients) had multiple stenotic lesions. Thirteen (52%) patients had three-vessel distal run-off to the foot, seven (28%) patients had two-vessel, and five (20%) patients had single-vessel run-off. The mean lesion length was 13 cm (range 12-18 cm). Results Twenty-five stents were implanted in 25 patients. Technical success was achieved in all patients. Primary patency was achieved in 17 (68%) patients, whereas restenosis occurred in eight (32%) cases. Of these eight cases, four patients were treated with angioplasty, one patient was treated with a femoropopliteal bypass, two cases were treated medically, and the last patient developed extensive necrotizing fasciitis that ended in limb amputation. Conclusion Management of long SFA lesions with a nitinol stent is effective and safe in patients with critical limb ischemia as there is still the opportunity to receive bypass surgery or endovascular reinterventions.