Endovascular Recanalization of Occluded Native Artery after Failed Lower Extremity Bypass Grafts

Introduction: This study aimed to investigate the feasibility, safety, and outcomes of endovascular recanalization for native superficial femoral artery (SFA) total occlusion (CTO) in patients with critical limb ischemia (CLI) after femoropopliteal bypass failure with limited surgical revascularization options.

Method(s): We retrospectively analyzed 18 consecutive patients (19 limbs). Endovascular intervention was performed for native SFA occlusion after failed femoropopliteal bypass from January 2017 to December 2021. According to the TransAtlantic Inter-Society Consensus for the Management of Peripheral Arterial Disease classification, all lesions were category D. Demographics, technical success, complications, vessel patency, and limb salvage rates were analyzed.

Result(s): Technical success rate was 94%. Stents were placed in seven patients. Primary and secondary patency at 6 and 12 months were 88%, 90%, and 61%, 72%, respectively. Two distal embolization was occurred during the procedure and treated with catheter-directed thrombolysis.

Conclusion(s): Revascularization of native SFA has a high technical success rate and effective procedure in CLI patients. Native SFA revascularization should be performed for limb salvage in inoperable CLI patients.

Publication History

Article published online:
09 February 2023