title: Treatment strategies for extensive chronic SFA occlusions: indications and results.
abstract: Treatment modalities for extensive chronic occlusive disease of the superficial femoral artery (SFA) have changed during the last decades. In this chapter we provide an overview of current treatment modalities for extensive chronic occlusive disease of the SFA. Although the autologous venous conduit is still considered the gold standard for treatment of long occlusive SFA lesions, endoluminal therapy is gaining territory. Its' minimal invasive character has great advantages in the frail vascular patient population. Percutaneous transluminal angioplasty is first choice in short SFA lesions, but patency rates decrease with longer lesions. When percutaneous transluminal angioplasty is combined with nitinol stent placement patency rates significantly improve. Patency rates of percutaneous transluminal angioplasty combined with covered stents are within reach of patency rates of prosthetic surgical bypasses. Drug-bonding in surgical PTFE bypasses increased patency rates significantly. In the near future drug-eluting and drug-bonded devices might further increase results of endovascular treatment.
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
authors.forename: M M A
authors.initials: MM
authors.lastname: Lensvelt
authors.forename: M M P J
authors.initials: MM
authors.lastname: Reijnen
authors.forename: B M
authors.initials: BM
authors.lastname: Wallis De Vries
authors.forename: C J
authors.initials: CJ
authors.lastname: Zeebregts
mesh_terms: D000792:Angiography; D000800:Angioplasty, Balloon / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002908:Chronic Disease; D054855:Drug-Eluting Stents; D005263:Femoral Artery; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D011474:Prosthesis Design; D012720:Severity of Illness Index
chemical_list: D010975:Platelet Aggregation Inhibitors