Evaluation of long superficial femoral artery stenting in a critically ischemic limb

Aim: The aim of the study was to evaluate 1-year efficacy and integrity of long stents implanted in the superficial femoral artery (SFA) in a critically ischemic limb. Patients and methods: A prospective study was carried out between July 2012 and September 2014 on 25 patients (19 men and six women, mean age 58 years, range 52–65 years) suffering from critical limb ischemia (Rutherford classifi cation 4 or 5) caused by a long SFA lesion who underwent stenting of the targeted segment at the 6th October Insurance Hospital (Dokki, Cairo, Egypt). Patients were scheduled to receive a single stent and were evaluated for 1 year. An overall 60% (15 patients) had occluded segments and 40% (10 patients) had multiple stenotic lesions. Thirteen (52%) patients had three-vessel distal run-off to the foot, seven (28%) patients had two-vessel, and fi ve (20%) patients had single-vessel run-off. The mean lesion length was 13 cm (range 12–18 cm). Results: Twenty-five stents were implanted in 25 patients. Technical success was achieved in all patients. Primary patency was achieved in 17 (68%) patients, whereas restenosis occurred in eight (32%) cases. Of these eight cases, four patients were treated with angioplasty, one patient was treated with a femoropopliteal bypass, two cases were treated medically, and the last patient developed extensive necrotizing fasciitis that ended in limb amputation. Conclusion: Management of long SFA lesions with a nitinol stent is effective and safe in patients with critical limb ischemia as there is still the opportunity to receive bypass surgery or endovascular reinterventions.