Revisiting of occluded native superficial femoral artery after femoropopliteal bypass occlusion in patients with critical limb ischemia using the endovascular approach

Abstract

Background Patients with graft occlusion have poor outcomes, with increased amputation rates. Reoperation is not feasible in some patients with critical limb ischemia owing to high surgical risk, unsuitable target vessels, or lack of conduit. Pertinent progress in endovascular techniques has provided more therapeutic options for patients with critical limb ischemia. Aim This study aimed to assess the short-term outcome of native superficial femoral artery endovascular revascularization in patients with occluded bypass. Patients and methods This is a retrospective study that was based on a prospectively maintained database of patients who attended our hospital with signs of chronic limb ischemia owing to occluded previous femoropopliteal bypass during the period from January 2019 to June 2021. Patients were invited for follow-up visits at 6 weeks and then at 3-month intervals. Results Technical success was achieved in all patients. At the end of the follow-up period, the primary patency rate was 56.14%, the assisted patency rate was 82.5%, and the secondary patency rate was 87.7%. The amputation-free survival rate was 87.7%, and the limb-salvage rate was 96.5%. Conclusion Endovascular recanalization is a feasible, effective, and safe alternative treatment choice for patients with chronic limb ischemia and failed previous graft bypass. It offers high rates of technical success, assisted primary and secondary patency, limb salvage, and amputation-free survival.