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    • Feasibility and Outcome of Endovascular Recanalization of Flush Superficial Femoral Artery Occlusions

    Ahmed Sayed1,2, Hussein Elwan1 , Walied Eldaly1 , Baker Ghonem1 , Morad Elkholy2 , Mohamed Ragab2 , Marwan Yousry1
    1Vascular Surgery Division, Kasr Alainy Faculty of Medicine, Cairo University 2Vascular Surgery Department , National Institute of Diabetes & Endocrinology

    Superficial femoral artery (SFA) chronic total occlusions (CTOs), especially in the ostial location, present the greatest operator challenge. The aim of this study is to evaluate the different techniques of crossing the superficial femoral artery flush occlusion in patients with critical limb ischaemia regarding the feasibility, patency, clinical success, limb salvage rates and complications. Patients and Methods: This retrospective study included patients with flush SFA occlusion and having critical limb ischemia for whom endovascular revascularization was performed, between January 2013 and January 2015. Result: The study included 94 patients with a mean age of 63 years, and male:female ratio 70:24. Technical success was achieved in 84%. After one year primary patency was 63%, secondary patency was 67%, and limb salvage rate was 81%. Subintimal angioplasty was used in 67 cases (71%), while the intraluminal route was used in 27 cases (29%). Stents were used in 43 patients. Retrograde popliteal or pedal access was used in 11 cases. Conclusion: Endovascular management of flush SFA occlusion is feasible with comparable midterm outcome. Retrograde access is a well-established and safe technique when antegrade recanalization fails. Keywords: Flush occlusion - superficial femoral artery - endovascular – retrograde. 

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