Retrograde Stent-Graft Angioplasty of Superficial Femoral Artery Occlusion in a Claudicant

Abstract

Endovascular therapy has become an accepted mode of therapy for lifestyle-limiting claudication, especially if the disease is confined to the superficial femoral artery (SFA). The standard approach to these lesions is from the contralateral femoral artery and crossing over the aortic bifurcation. In patients who have an aortobifemoral bypass (AFB), this technique is usually not feasible secondary to the angles of the graft. The authors report on their approach to a 60-year-old man with lifestyle-limiting claudication and SFA disease, and an AFB in place. They performed a retrograde approach to the SFA via a small above-knee popliteal artery exposure. They used the recently approved (in the United States) heparin-bonded VIABAHN for the revascularization via this approach, which would have allowed them to proceed to an open bypass procedure if they were unsuccessful in the same setting.

Keywords

endovascular VIABAHN heparin stent-graft superficial femoral artery peripheral arterial disease

Get full access to this article

View all access options for this article.

References

Dormandy JA , Rutherford RB Management of peripheral arterial disease (PAD). TASC Working Group. Trans Atlantic Inter-Society Consensus (TASC). J Vasc Surg. 2000;31:S1-S296.

White R. , Krajcer Z. , Johnson M. , Williams D. , Bacharach M. , O'Malley E. Results of a multicenter trial for the treatment of traumatic vascular injury with a covered stent. J Trauma. 2006;60:1189-1195.

Bosiers M. , Deloose K. , Verbist J. , et al. Heparin-bonded expanded polytetrafluoroethylene vascular graft for femoropopliteal and femorocrural bypass grafting: 1-year results. J Vasc Surg. 2006;43:313-318.

Curi MA , Geraghty PJ , Merino OA , et al. Mid-term outcomes of endovascular popliteal aneurysm repair . J Vasc Surg. 2007;45:505-510.

Nelson PR , Anthony LW Endovascular treatment of popliteal artery aneurysms. Vascular . 2006;14:297-304.

Geraghty PJ Covered stenting of the superficial femoral artery using the Viabahn stent graft. Perspect Vasc Surg Endovasc Ther. 2006 ;18:39-45.

Haude M. , Konorza TF , Kalnins U. , et al. Heparin-coated stent placement for the treatment of stenoses in small coronary arteries of symptomatic patients. Circulation . 2003;107:1265-1270.