60: Chronic Occlusion of a Superficial Femoral Artery

Published on 02/03/2015 by admin

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Last modified 02/03/2015

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CASE 60 Chronic Occlusion of a Superficial Femoral Artery

Angiography

Arterial access was obtained in the left common femoral artery and a 4 French Omniflush catheter was used to perform angiography. Aortography confirmed wide patency of the common iliac stents (Figure 60-2). Selective right femoral angiography and runoff was performed by passing a hydrophilic glide wire over the bifurcation using the Omniflush catheter and then exchanging for a 4 French RIM catheter. Angiography found a mild stenosis in the common femoral artery, followed by a diffusely diseased segment of the proximal SFA of moderate stenosis and then a long segment of total occlusion (Figure 60-3). There was reconstitution of the distal SFA above the adductor canal via collaterals from the profunda femoris (Figures 60-4 through 60-6). Below the knee, the anterior tibial was occluded; however,two-vessel runoff was present to the foot via the posterior tibial and peroneal arteries. Based on the patient’s profound symptoms, her anatomy, and her comorbid conditions, it was decided to proceed with an intervention to the right SFA.

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