Journal «Angiology and Vascular Surgery» • 

1999 • VOLUME 5 • №4


P.V. Tisi, Frcsed, A.R. Cowan, Frcs, G.E. Morris, Dm Mch Frcs
Department of Vascular Surgery, Southampton General Hospital,
Southampton, UK

Objectives: The management of superficial femoral artery (SFA) occlusive disease remains controversial. The difficult question to answer is how best to treat those who continue to deteriorate despite maximal conservative treatment. Short segment stenoses or occlusions can usually be treated by balloon angioplasty, although more technically difficult lesions can now be treated with a sub-intimal technique. However, the long-term patency rates for angioplasty remain disappointing. This article reviews current endovascular treatment strategies for long superficial femoral artery occlusions in order to try and answer this question.

Design: A Medline search was conducted to identify articles relating to atherectomy, endarterectomy and endoluminal bypass grafting for SFA occlusive disease.

Outcome measures: Long-term patency and complication rates.

Conclusions: The role of atherectomy for SFA disease is limited due to poor long-term patency rates. Newer methods of endarterectomy and endoluminal bypass grafting are technically feasible, although the long-term results do not yet support their routine use. Further experimental and clinical work is needed to overcome some of the technical limitations of these procedures. These treatments may then be able to offer a real alternative to conventional bypass surgery in those patients with a deteriorating claudication distance.

KEY WORDS: angioplasty, atherectomy, endarterectomy, endovascular surgery, claudication.

P. 31-40

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