RETROGRADE TRANSLUMINAL ANGIOPLASTY FOR L ONG-SEGMENT OCCLUSION OF THE SUPERFICIAL FEMORAL-ARTERY

In a prospective study between March 1992 and October 1993, 50 consecu tive patients (47 men, three women; mean age 59.7 [42-73] years) with a total of 52 occlusions of the superficial femoral artery underwent r etrograde recanalization via the popliteal artery. The patients were i n clinical stage IIa (n = 7), IIb (n = 38) or III (n = 5). The mean Do ppler ratio (ankle/arm) was 0.51 +/- 0.14, mean length of occlusion 19 +/- 9 [4-40] cm. Popliteal puncture was successful in all patients bu t one. The occlusion was passed by guide-wire in 38, subsequently by b alloon catheter in 37. Additional laser angioplasty had to be performe d in five patients, while stent implantation was necessary in another five. 35 of 52 vessels (in 33 patients) remained open and free of sign ificant stenosis after the procedure. The mean ankle/arm Doppler ratio was 0.5 +/- 0.13 immediately before the angioplasty, 0.72 +/- 0.17 (P < 0.05) immediately afterwards. There were no complications ascribabl e to the technique except in two cases in which an asymptomatic arteri ovenous fistula developed. These results 9 indicate that retrograde re canalization of the superficial femoral artery is a relatively reliabl e and successful catheter technique in patients who would otherwise ha ve to be treated by surgery.