Diameter of Occluded Superficial Femoral Arteries Limits Percutaneous Recanalization: Preliminary Results

Abstract

Purpose:

To explore if the diameter of an occluded superficial femoral artery (SFA) can predict the technical success of percutaneous recanalization.

Methods:

Two hundred patients (151 men; mean age 57 ± 16 years) suffering from peripheral arterial occlusive disease were evaluated with duplex ultrasonography to measure arterial diameters and percent diameter reduction. Seventy-nine (39.5%) patients had segmental or complete SFA occlusions that ranged in age from 2 to 26 months (median 11). The majority of occlusions (45, 57.0%) were ≤10 cm long (range 10–35). Percutaneous recanalization was performed in 71 patients using either conventional angioplasty or local low-dose thrombolysis with rtPA.

Results:

Diameters of 79 unilaterally occluded SFAs at the level of occlusion were 4.5 ± 1.4 mm versus 5.7 ± 1.3 mm for the patent contralateral artery (p=0.055). None of the 121 patent SFAs had diameters ≤3.5 mm, but 12 (15%) of the 79 occluded SFAs did, and none of these could be recanalized. The sensitivity of the 3.5-mm cut point to predict recanalization failure was 44% (specificity 100%).

Conclusions:

Our data suggest that occluded SFAs with a diameter reduction to ≤3.5 mm are not suitable for percutaneous recanalization, as the original arterial lumen cannot be reconstructed.