Guidelines adherence or chronic total occlusion recanalization of the superficial femoral artery with a stentless approach : The next frontier?

Rammos, Christos LSF; Radecke, Tobias; Lortz, Julia LSF; Steinmetz, Martin LSF; Rassaf, Tienush LSF

In patients with intermittent claudication and long chronic total occlusions of the superficial femoral artery, a primary surgical bypass or stenting is recommended. However, due to the invasive nature, high complication rates and patient-related comorbidities, surgery is currently not the preferred method and full lesion stenting for long chronic total occlusions has the obvious consequences of permanent metallic implants. We report a case of a patient with a long chronic total occlusion of the superficial femoral artery with intermittent claudication. Endorsing an endovascular-first strategy, he was treated via an antegrade and retrograde approach with a complete recanalization and a stentless treatment with rotational atherectomy and drug-coated balloons. We believe this is a feasible endovascular strategy for the treatment of long chronic total occlusions of the superficial femoral artery for patients refusing open surgery. Further investigations are needed to evaluate long-term clinical outcomes of these novel techniques.

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Rammos, Christos / Radecke, Tobias / Lortz, Julia / et al: Guidelines adherence or chronic total occlusion recanalization of the superficial femoral artery with a stentless approach. The next frontier?. 2019.

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