000K utf8 1100 2019$c2019-01-11 1500 eng 2050 urn:nbn:de:hbz:464-20190320-154304-1 2051 10.1177/2050313X18823445 3000 Rammos, Christos 3010 Lortz, Julia 3010 Radecke, Tobias 3010 Rassaf, Tienush 3010 Steinmetz, Karl Martin 4000 Guidelines adherence or chronic total occlusion recanalization of the superficial femoral artery with a stentless approach$dThe next frontier? [Rammos, Christos] 4209 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. 4950 https://doi.org/10.1177/2050313X18823445$xR$3Volltext$534 4950 https://nbn-resolving.org/urn:nbn:de:hbz:464-20190320-154304-1$xR$3Volltext$534 4961 https://duepublico2.uni-due.de/receive/duepublico_mods_00048451 5010 61 5051 610 5550 atherectomy 5550 chronic total occlusion 5550 drug-coated balloon 5550 Superficial femoral artery