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

Background and objective: The treatment of long chronic occlusion of periph eral arteries remains unsatisfactory. In particular occlusions of the super ficial femoral artery (SFA) are not considered suitable for percutaneous in terventions. It was the aim of our study to evaluate this technique, the in itial 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 me an occlusion length was 21.9 +/- 14,8cm. At baseline absolute treadmill wal king distance was 125 +/- 61 m. In all cases a ballon angioplasty was perfo rmed, additional excimer laser in 80.8% and stenting in 50.9%. Results: A primary technical success was achieved in 89.0%. According to th e 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 se condary patency rate was 85.5% and 69.1 % respectively. Conclusion: Long chronic occlusion can be successfully treated by percutane ous techniques. To maintain a high patency rate frequent clinical follow-up is mandatory.