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Background: Superficial femoral artery (SFA) In-Stent Restenosis (ISR) is a commonly encountered problem. Due to heterogeneous patient and angiographic characteristics, endovascular treatment of SFA-ISR continues to evolve. Successful treatment via traditional transfemoral approach (TFA) is limited due to complication rates as high as 10%, including thromboembolism, slow flow and acute vascular closure. Using a retrograde transpedal approach (TPA) and revascularizing the outflow tibial obstruction may reduce these complications.
Methods: We analysed prospectively collected data on patients who underwent endovascular SFA-ISR intervention using TPA, from 8/2015 to 9/2016. Primary endpoint was 6 month major adverse events (MAE) – death, amputation and target vessel revascularization (TVR). Secondary endpoint was peri-intervention thromboembolism, slow flow, acute closure, access site patency and complication at 30 days.
Results: A total of 52 SFA-ISR lesions underwent endovascular intervention in 43 patients (Age 76 years. Rutherford Class 3–5 100%) (Table). Procedural success rate was 100%. The 6 months MAE was 17.3% (only TVR – 9). There were no peri-intervention thromboembolism, slow flow or acute closure. At 30 days, ultrasound confirmed access site patency without any complication.
Conclusions: In patients with SFA-ISR and concomitant tibial obstructive disease, routine TPA and tibial artery intervention is both safe and feasible and may reduce TFA associated complications.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Head to Toe: Outcomes of Endovascular Interventions
Abstract Category: 18. Interventional Cardiology: Carotid and Endovascular Intervention
Presentation Number: 1112-127
- 2017 American College of Cardiology Foundation