Ipsilateral Antegrade Access for Management of Ostial and Near Ostial SFA Occlusive Lesions; Appraisal of New Techniqe

A.A.Ghani, A.A.El Samadoni, H.S.Afifi and M.M.kenawy"


Peripheral arterial disease (PAD) is a major world-wide health problem affects 12%–14% of the general population. PAD of the superficial femoral artery (SFA) is the most common cause of intermittent claudication. Critical limb ischemia (CLI) is the most severe form of PAD. CLI is associated with a higher risk of limb loss in the absence of revascularization.The aim of this work is to evaluate the feasibility and to demonstrate the effectiveness of proposed technique of ipsilateral antegrade management of ostial and near ostial SFA occlusive lesions.This study was conducted on (20) Patients with critical lower limb ischemia and ostial and near ostial SFA lesions in the form of rest pain and tissue loss. The study period started from May 2017 until March 2019. Patients included in the study were essentially attending the Vascular Outpatient Clinic at Benha University Hospitals and Nasser Institute for Search & Treatment at Cairo and treated by ipsilateral antegrade SFA angioplasty. From the 20 patients of our study who underwent ipsilateral antegrade SFA angioplasty around 17 cases (85%) showed technical success "the guidewire crossed the lesion", while in the other 3 cases the guidewire couldn‟t be passed through the lesion. Endovascular therapy (EVT) in ostial and near ostial SFA occlusive lesions with ipsilateral antegrade access through common femoral artery puncture is a feasible and effective approach. It is the only baile out alternative method for the preferred approach "contralateral crossover" to the extremely tortuous iliac arteries, hostile aortic bifurcations, and abdominal aortic stent grafts.

Key words

Antegrade, Revascularization, Ostial SFA Angioplasty.