PT Unknown AU Rammos Dr. med., C Radecke, T Lortz Dr. med., J Steinmetz Dr. med., M Rassaf Prof. Dr., T TI Guidelines adherence or chronic total occlusion recanalization of the superficial femoral artery with a stentless approach: The next frontier? PD 01 PY 2019 DI 10.1177/2050313X18823445 LA en DE Superficial femoral artery; drug-coated balloon; atherectomy; chronic total occlusion AB 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. ER