Efficacy Analysis Of Retrograde Recanalization Technique For Long Segmental Occlusion Of Superficial Femoral Artery

Objective:Long segmental occlusion of superficial femoral artery is the common clinical problem of vascular surgery,which is also the current therapeutic difficulty and hot spot.By analyzing the clinical datas of 32 patients with long segmental occlusion of superficial femoral artery,to evaluate the safey and efficacy of retrograde recanalization technique in treatment of long segmental occlusion of superficial femoral artery,so that it can provide certain theoretical basis for the treatment of long segmental occlusion of superficial femoral artery.Methods:The clinical datas of 32 patients with long segmental occlusion of superficial femoral artery treated from february 2016 to march 2017 in the fifth affiliated hospital of ZhengZhou university was analyzed.All the patients treated by retrograde recanalization technique after the failed anterograde recanalization technique.The mean follow-up time was 12 months.The results of complication,ankle brachial index,intermittent claudication,Rutherford category and patency rate were recorded.And SPSS 21.0 was used to compare ABI,rutherford category,intermittent claudication,patency rate.Results:1.Complication: hematoma of puncture site was observed in 2 patients,other complications included acute myocardium infarction in 1 case and acute stent thrombosis in 1 case,no amputation needed or death occurred and the incidence of complications was 12.5%(4/31).2.ABI and changes of Rutherford class:The ABI increased from 0.29±0.21 before the treatment to 0.82±0.19 at 24 h,0.81±0.12 at 7d,0.73±0.07 at 3 months,0.70±0.16 at 6 months,and 0.65±0.09 at 12 months after the treatment.The ABI of 24 h,7d,3,6,12 months postoperation increased significantly compared with peroperation(both P < 0.05).The Rutherford class were increased in all patients.3.Intermittent Claudication : The intermittent claudication increased from(136.21±32.55)m before the treatment to(559.15±82.11)m at 24 h,(549.45±72.15)m at7 d,(521.15±62.18)m at 3 months,(508.22±47.21)m at 6 months,and(447.31±52.11)at 12 months after the treatment.The Intermittent Claudication of 24 h,7d,3,6,12 months postoperation increased significantly compared with peroperation(both P < 0.05).4.Target vessel primary patency rate:The target vessel primary patency rate at 3,6 and 12 months after operation were 96.88%,90.63% and 71.88%? Conclusions:1.retrograde recanalization technique could be used to as an safety alternative strategy for long segmental occlusiopon of superficial femoral artery when the occluded segment could not reach through anterograde access.2.retrograde recanalization technique has good clinical efficacy and safety in treatment of long segmental occlusion of superficial femoral artery.