Assessment of Retrograde Recanalization by using Balloon Angioplasty for Long Segment Superficial Femoral Artery Occlusion

Abd El-Rahman, Mohamed Abd El-Hamid; Zakaria, Mohamed Yahia; Eltony, Mahmoud Abdelaziz Abdelrahman; Mohamed, Mohamed Ali Abd El-Rheem

doi:10.21608/aimj.2025.446535

Assessment of Retrograde Recanalization by using Balloon Angioplasty for Long Segment Superficial Femoral Artery Occlusion

Document Type : Original Article

Authors

Vascular Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

10.21608/aimj.2025.446535

Abstract

Background: The most common cause of peripheral arterial disease (PAD) and claudication is disease of the superficial femoral artery (SFA). The prevalence of PAD is increasing, with recent estimates putting the number of affected individuals at around 200 million. About 20% of PAD patients experience claudication, and nearly 50% show no symptoms at all.
Aim and objectives: Evaluation of retrograde angioplasty for the treatment of SFA occlusive illnesses following the failure of antegrade recanalization procedure with respect to limb salvage rates in cases of chronic lower limb-threatening ischemia, secondary patency rate, comorbidities, and overall success rate.
Patients and methods: Thirty patients presenting to the Vascular Departments of Al-Azhar University Hospitals (Cairo) and Military Hospitals between August 2021 and June 2023 with chronic lower limb threatening ischemia and SFA occlusive diseases (Rutherford classification category 2 to 6), comprised one arm of this prospective study clinical trial.
Results: Our technical success in crossing the lesion was 90% with only 10-patients needed stenting. Our follow up Primary patency rate after 12-months was 75% and secondary patency rate was 100% after 24-months.
Conclusion: In cases of SFA atherosclerotic occlusive diseases, endovascular procedures are thought to be safe and effective management options. This is especially true for retrograde access procedures, which have a high technical success rate and a high percentage of lower limb salvage in cases of chronic lower limb threatening ischemia. Our results demonstrated that recanalization of SFA complete blockage with proximal PA lesion can be accomplished safely and effectively using the US guided retrograde popliteal artery (RPA) endovascular method.

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