RT Book, Section
A1 Ellison, E. Christopher
A1 Zollinger, Jr., Robert M.
A1 Pawlik, Timothy M.
A1 Vaccaro, Patrick S.
A1 Bitans, Marita
A1 Baker, Anthony S.
SR Print(0)
ID 1187824696
T1 Superficial Femoral Artery Interventions and Stenting
T2 Zollinger’s Atlas of Surgical Operations, 11e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781260440850
LK accesssurgery.mhmedical.com/content.aspx?aid=1187824696
RD 2023/03/31
AB The  superficial  femoral  artery  is  the  most  common  lower  extremity  artery  affected  by  occlusive  disease  in  the  body.  The  indications  for  treating  superficial  femoral  artery  occlusive  disease  with  minimally  invasive  endovascular  techniques  follow  classic  vascular  surgical  guidelines  for  treating  all  lower  extremity  occlusive  disease:  lifestyle-limiting  claudication,  ischemic  rest  pain,  and  tissue  loss.  Specific  treatment  options  include  plain  old  balloon  angioplasty,  balloon  angioplasty  and  stenting,  and  atherectomy.  This  chapter  focuses  on  balloon  angioplasty  and  stenting.  There  are  limitations  when  considering  applying  minimally  invasive  techniques  to  treat  superficial  femoral  artery  blockage,  and  these  are  primarily  based  on  anatomic  variables.  Specifically,  lesions  that  are  longer  than  10  cm  and  severe  calcification  limit  the  effectiveness  of  using  endovascular  therapy.  In  addition,  there  is  concern  for  kinking  when  implanting  stents  across  the  popliteal  fossa.  Finally,  patients  with  extensive  tissue  loss  have  limited  options,  and  many  still  consider  saphenous  vein  bypass  to  provide  pulsatile  flow  in  these  circumstances  as  the  gold  standard.