YÜZEYEL FEMORAL ARTER STENOZ VE OKLÜZYONLARINDA ENDOVASKÜLER TEDAVİ

Amaç: Bu çalışmada, yüzeyel femoral arter stenoz ve oklüzyonlarında endovasküler yolla tedavi edilen has-talarda deneyimin, teknik başarının ve periprosedüral komplikasyonlara yaklaşımın sunulması amaçlandı.Gereç ve Yöntemler: Haziran 2012 ve Aralık 2018 tarihleri arasında hastanemiz girişimsel radyoloji ünitesineyürüme ağrısı ve kritik ayak iskemisi nedeniyle yönlendirilen, yüzeyel femoral arterde stenoz veya oklüzyonsaptanan 40 hastanın (11 kadın, 29 erkek) kayıtları retrospektif olarak incelendi. Hastalar tedavi kararı ön-cesinde klinik öykü ve bulgularının yanı sıra Doppler US, BT anjiyo veya dijital subtraksiyon anjiyografi iledeğerlendirildi. İşlemi kabul eden hastalara endovasküler tedavi ile primer perkütan translüminal anjiyop-lasti ve ihtiyaç halinde stentleme uygulandı. İşlem sonrası hastalar erken dönem komplikasyonlar açısındantakip edildi.Bulgular: Çalışmaya dahil edilen yüzeyel femoral arterde oklüzyon veya stenoz olan hastalar endovasküleryöntemlerle tedavi edildi. Ortalama oklüde segment uzunluğu 132.3 mm ölçüldü (aralık=15-280 mm). Pri-mer PTA ile tedavi, stenotik ve oklüde segmentler geçildikten sonra hastaların %80’inde başarıyla gerçekleş-tirildi. Yeterli lümen patensi sağlanamayan veya PTA’ya yanıtsız diseksiyon gelişen %20 hastada ise ek olaraksüper elastik özel nitinol örgülü kendiliğinden açılabilen stent uygulanarak patensi sağlandı. Endovaskülertedavinin teknik başarı oranı %100 olarak hesaplandı. Dört hastada diseksiyon ve bir hastada distal emboliolmak üzere toplam beş hastada (%12.5) işlem esnasında komplikasyon gelişti ve bu hastalar yine endovas-küler yöntemlerle tedavi edildi.Sonuç: Yüzeyel femoral arterde perkütan translüminal anjiyoplasti ve stentleme işleminin teknik başarıoranları yüksek ve komplikasyon oranları düşüktür. Gelişen malzeme kalitesi ve teknikler ile endovasküleryöntemler ile tedavi edilebilen hasta sayısı daha da artacaktır.

Endovascular Treatment of Superficial Femoral Artery Stenosis and Occlusions

Aim: In this study, it is aimed to present the experience, technical success and management of the periprocedural complications in patients treated with endovascular treatment of superficial femoral artery stenosis and occlusion. Materials and Method:A total of 40 patients (11 women, 29 men) with superficial femoral artery stenosis or occlusion between June 2012 and December 2018 referred to our interventional radiology unit with symptoms of claudication and critical limb ischemia were retrospectively analyzed. The patients were evaluated with Doppler US, CT angiography or digital subtraction angiography in addition to clinical history and findings before treatment decision. The patients who accepted the procedure underwent endovascular treatment with primary percutaneous transluminal angioplasty and stenting if necessary. Patients were followed up for early complications. Results: The patients with occlusion or stenosis in the superficial femoral artery were treated with endovascular methods. The mean length of the occluded segment was measured as 132.3 mm (range = 15-280 mm). Treatment with primary PTA was successfully performed in 80% of patients after crossing the stenotic and occluded segments. Lumen patency in 20% of the patients with a resistant lesion or unresponsive dissection to PTA was achieved by self-expandable superelastic nitinol stent. The technical success rate of endovascular treatment was 100%. Complications occurred in five patients (12.5%) and treated with endovascular methods, including dissection in four patients and distal embolism in one patient. Conclusion: Percutaneous transluminal angioplasty and stenting procedures of the superficial femoral artery are performed with high technical succes and low complication rates. The number of patients treated with endovascular methods will increase with developing material quality and techniques.

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