[Retrograde catheter recanalization of long-range occlusion of the superficial femoral artery].

In a prospective study between March 1992 and October 1993, 50 consecutive patients (47 men, three women; mean age 59.7 [42-73] years) with a total of 52 occlusions of the superficial femoral artery underwent retrograde recanalization via the popliteal artery. The patients were in clinical stage IIa (n = 7), IIb (n = 38) or III (n = 5). The mean Doppler ratio (ankle/arm) was 0.51 +/- 0.14, mean length of occlusion 19 +/- 9 [4-40] cm. Popliteal puncture was successful in all patients but one. The occlusion was passed by guide-wire in 38, subsequently by balloon catheter in 37. Additional laser angioplasty had to be performed in five patients, while stent implantation was necessary in another five. 35 of 52 vessels (in 33 patients) remained open and free of significant stenosis after the procedure. The mean ankle/arm Doppler ratio was 0.5 +/- 0.13 immediately before the angioplasty, 0.72 +/- 0.17 (P < 0.05) immediately afterwards. There were no complications ascribable to the technique except in two cases in which an asymptomatic arteriovenous fistula developed. These results indicate that retrograde recanalization of the superficial femoral artery is a relatively reliable and successful catheter technique in patients who would otherwise have to be treated by surgery.