The present state of the art of the pathophysiology, diagnosis and treatment of the superficial femoral artery occlusion based on own results
Journal Title: Postępy Nauk Medycznych - Year 2012, Vol 25, Issue 8
Abstract
<b>Introduction.</b> Due to their fast development, endovascular techniques supersede the sclerotic embolisations and occlusion of the superficial femoral artery treatment methods used so far. According to the present state of the art, endovascular methods are the primary treatment even in most severe sclerotic changes.<br><b>Materials and methods. </b>The authors of the present paper work in the clinic where 170 procedures were performed at 157 patients in the past 3 years. In 48% the procedures consisted in recanalisation of superficial femoral artery followed by the implantation of a self- expanding stent. In 31.5% cases, only a balloon angioplasty was performed whereas in 11.5% cases cryoplasty alone. In 9% cases, being the equivalent of 16 patients, the endovascular procedure was performed by means of mechanical trombectomy.<br><b>Results.</b> After three years and with the participation of 90 patients, it was observed that primary patency rate in patients in which only balloon angioplasty was performed was 19%, but limb salvage rate amounts 25%. In the group of patients with an implanted stent, the number of artery patency after two years of observations was 57%, whereas in 68% the limb was saved. Out of 20 patients treated with cryoplasty 13 were subject to a three year observation. In 5 cases (38%), due to restenosis, it was necessary to repeat the stent implantation. The number of severe complications, such as a death or a loss of a limb 30 days after the treatment, amounted to 2%, whereas during a three year observation to 1%.<br><b>Conclusions. </b>Endovascular procedures are recommended as first priority irrespective of how advanced is the lower limb arteries sclerosis. Because balloon angioplasty and nitinol stents implantations only result in a low number of patency of superficial femoral artery, stents and drug eluting baloons are considered a good alternative in those kind of changes.
Authors and Affiliations
Andrzej Gabrusiewicz, Piotr Słowiński, Tomasz Krosny, Walerian Staszkiewicz
Keywords
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