Percutaneous revascularization of long chronic occlusion of the superficial femoral artery - a pilot study

Background and objective: The treatment of long chronic occlusion of peripheral arteries remains unsatisfactory. In particular occlusions of the superficial femoral artery (SFA) are not considered suitable for percutaneous interventions. It was the aim of our study to evaluate this technique, the initial technical success and the follow-up patency rates after percutaneous revascularization of long chronic occlusion of the the SFA. Patients and methods: 58 consecutive patients (mean age 64.8 +/- 9,7/40-80 years, 40 men/69.0%) were included. Of these patients 15 had bilateral SFA-occlusions and 14 showed additional disease in the popliteal artery. The mean occlusion length was 21.9 +/- 14,8cm. At baseline absolute treadmill walking distance was 125 +/- 61 m. In all cases a ballon angioplasty was performed, additional excimer laser in 80.8% and stenting in 50.9%. Results: A primary technical success was achieved in 89.0%. According to the American Heart Association guidelines a markedly clinical improvement was shown: +3 in 16,2%, +2 in 74,4%, +1 in 9,3% of the patients. The 12-months cumulative primary patency rate was 43.6%, primary assisted patency and secondary patency rate was 85.5% and 69.1 % respectively. Conclusion: Long chronic occlusion can be successfully treated by percutaneous techniques. To maintain a high patency rate frequent clinical follow-up is mandatory.