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

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

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, C., Radecke, T., Lortz, J., Steinmetz, M., Rassaf, T., 2019. Guidelines adherence or chronic total occlusion recanalization of the superficial femoral artery with a stentless approach: The next frontier? https://doi.org/10.1177/2050313X18823445
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