Treatment of superficial femoral artery occlusive disease

Abstract

The aim of this paper was to compile a literature summary of current treatment modalities for the treatment of superficial femoral arterial (SFA) disease. The English-language literature was searched for studies describing the treatment of SFA occlusive disease using surgical bypass (vein or prosthetic), percutaneous bypass (stent-grafts), bare stents, percutaneous transluminal angioplasty (PTA), and subintimal angioplasty (SA). Inclusion criteria for articles were presentation of primary patency rates, a minimum study population of 10, and baseline characteristics of the study population. Average primary and secondary patency rates for each treatment modality were obtained by weighting the results of each trial by the number of limbs treated. All identified papers were included in the summary, regardless of the study inclusion/exclusion criteria, comorbidities, or patient population. Since the study conditions and patient populations varied widely, this is not intended to be a meta-analysis or for use in directly comparing the efficacy of different treatment modalities; rather, it is to provide general information on their performance under the reported conditions. One hundred and twelve studies met the inclusion criteria for the 6 treatment modalities identified. Compilation of the data revealed different patient populations for the different treatment modalities. For example, PTA was generally used to treat short, stenotic lesions, while endografts and SA were generally used for longer, total occlusions. For this reason, patency rates for the different treatment modalities cannot be directly compared.