Hybrid revascularization of chronic total occlusion of thè superficial femoral artery

The distribution of peripheral arterial disease (PAD) shows that more than 15% of lesions are localized in thè femoro-popliteal area. Chronic total occlusions (CTOs) of thè superficial femoral artery (SFA) pose a particular challenge and have been considered a traditionally surgical field for many decades. In thè last years a wide range of therapeutic modalities have emerged addressing to thè endovascular treatment of stenosis and occlusions. The BASIL trial showed that thè rates of amputation-free survival after surgery and balloon angioplasty were similar, at least for thè first two years.1 Nitinol stents may be an effective alternative to surgical revascularization for longer lesions in patients with severe comorbidities. It has been demonstrated that stenting may be a suitable option for patients not eligible for saphenous vein grafts and thè 12-month patency data are similar to those for prosthetic bypass grafts with considerably lower rate of complications.2 On thè other hand, thè endovascular approach could be limited in a few patients by inability to enter thè lumen when there is a cylindrical calcification or a heavily calcified plaque involving thè common femoral artery (CFA) bifurcation with thè occlusion of thè SFA at thè origin. The purpose of this study was to investigate thè early and late outcome after complete recanalization of SFA occlusion by using of a hybrid technique.