Subintimal angioplasty for superficial femoral artery occlusions: first experience in Kaunas University of Medicine Hospital

Nerijus Aleksynas, Rytis Stasys Kaupas^{1, 2}

Department of Cardiac Surgery, ¹Clinic of Radiology, ²Laboratory of Invasive Cardiology, Institute of Cardiology, Kaunas University of Medicine, Lithuania

Key words: subintimal angioplasty; chronic occlusion; superficial femoral artery; TransAtlantic Inter-Society Consensus criteria.

Summary. Objective. To assess prospectively the first experience of subintimal angioplasty of superficial femoral artery occlusions.

Patients and methods. Within a period of 36 months, 45 patients with 45 chronic occlusions in superficial femoral artery were treated at Kaunas University of Medicine Hospital.

Results. The technical success rate was 84.4%, and four failures were treated by conventional surgery. The following complications occurred: one hematoma at the arterial puncture site, one artery spasm, and two distal embolizations. The mean length of occlusions was 14.2±1.4 cm. The mean ankle-brachial index improved from 0.41±0.15 to 0.81±0.04 after successful subintimal angioplasty (P<0.001). Primary assisted patency rates were 94.7%, 92.1%, 84.2%, 81.6%, and 81.6% at 1, 3, 6, 12, and 24 months, respectively. The limb salvage rates were 100% and 97.8% at 1–3 and 6–12–24 months, respectively. There were no treatment-related amputations.

Conclusions. Subintimal angioplasty of occluded superficial femoral artery is a safe and minimally invasive procedure with a high initial technical success rate, low complication rate, and good early results, and in case of failure, subsequent surgery can be performed.

Correspondence to N. Aleksynas, Department of Cardiac Surgery, Kaunas University of Medicine, Eivenių 2, 50009 Kaunas, Lithuania. E-mail: nalex@takas.lt

Received 13 December 2005, accepted 3 December 2006