DOI QR코드

DOI QR Code

SFA Intervention: Intraluminal or Subintimal?

  • Ko, Young-Guk (Division of Cardiology and Cardiovascular Research Institute, Severance, Cardiovascular Hospital, Yonsei University College of Medicine)
  • Received : 2018.06.28
  • Accepted : 2018.07.10
  • Published : 2018.08.30

Abstract

Subintimal angioplasty (SA) is an endovascular technique to recanalize an occluded arterial segment through an extraluminal channel between the intima and media. Since its introduction in 1989, the technical success rate has improved with the accumulation of procedural experience and the development of retrograde approaches and re-entry devices. To date, no randomized trial has compared SA with intraluminal angioplasty (IA) for chronic total occlusion (CTO) of the superficial femoral artery (SFA). Based on limited data from several registry studies, SA appears to achieve a higher technical success rate than IA, whereas mid-term primary patency rates are comparable for both endovascular wiring strategies for SFA CTO. Additional clinical data are needed to confirm that SA is as effective as IA. The optimal stenting strategy and role of drug-eluting technologies also need to be defined to improve SA outcomes.

Keywords

References

  1. Ko YG, Ahn CM, Min PK, et al. Baseline characteristics of a retrospective patient cohort in the Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Diseases (K-VIS ELLA) Registry. Korean Circ J 2017;47:469-76. https://doi.org/10.4070/kcj.2017.0020
  2. Bolia A, Brennan J, Bell PR. Recanalisation of femoro-popliteal occlusions: improving success rate by subintimal recanalisation. Clin Radiol 1989;40:325.
  3. London NJ, Srinivasan R, Naylor AR, et al. Subintimal angioplasty of femoropopliteal artery occlusions: the long-term results. Eur J Vasc Surg 1994;8:148-55. https://doi.org/10.1016/S0950-821X(05)80450-5
  4. Reekers JA, Kromhout JG, Jacobs MJ. Percutaneous intentional extraluminal recanalisation of the femoropopliteal artery. Eur J Vasc Surg 1994;8:723-8. https://doi.org/10.1016/S0950-821X(05)80653-X
  5. McCarthy RJ, Neary W, Roobottom C, Tottle A, Ashley S. Short-term results of femoropopliteal subintimal angioplasty. Br J Surg 2000;87:1361-5. https://doi.org/10.1046/j.1365-2168.2000.01633.x
  6. Yilmaz S, Sindel T, Yegin A, Luleci E. Subintimal angioplasty of long superficial femoral artery occlusions. J Vasc Interv Radiol 2003;14:997-1010. https://doi.org/10.1097/01.RVI.000008261.05622.B8
  7. Laxdal E, Jenssen GL, Pedersen G, Aune S. Subintimal angioplasty as a treatment of femoropopliteal artery occlusions. Eur J Vasc Endovasc Surg 2003;25:578-82. https://doi.org/10.1053/ejvs.2002.1899
  8. Smith BM, Stechman M, Gibson M, Torrie EP, Magee TR, Galland RB. Subintimal angioplasty for superficial femoral artery occlusion: poor patency in critical ischaemia. Ann R Coll Surg Engl 2005;87:361-5.
  9. Treiman GS, Treiman R, Whiting J. Results of percutaneous subintimal angioplasty using routine stenting. J Vasc Surg 2006;43:513-9. https://doi.org/10.1016/j.jvs.2005.11.015
  10. Schmieder GC, Richardson AI, Scott EC, Stokes GK, Meier GH 3rd, Panneton JM. Selective stenting in subintimal angioplasty: analysis of primary stent outcomes. J Vasc Surg 2008;48:1175-80. https://doi.org/10.1016/j.jvs.2008.05.080
  11. Marks NA, Ascher E, Hingorani AP, Shiferson A, Puggioni A. Gray-scale median of the atherosclerotic plaque can predict success of lumen re-entry during subintimal femoral-popliteal angioplasty. J Vasc Surg 2008;47:109-15. https://doi.org/10.1016/j.jvs.2007.09.039
  12. Setacci C, Chisci E, de Donato G, Setacci F, Iacoponi F, Galzerano G. Subintimal angioplasty with the aid of a re-entry device for TASC C and D lesions of the SFA. Eur J Vasc Endovasc Surg 2009;38:76-87. https://doi.org/10.1016/j.ejvs.2009.03.020
  13. Kocher M, Cerna M, Utikal P, et al. Subintimal angioplasty in femoropopliteal region-Mid-term results. Eur J Radiol 2010;73:672-6. https://doi.org/10.1016/j.ejrad.2008.12.019
  14. Siablis D, Diamantopoulos A, Katsanos K, et al. Subintimal angioplasty of long chronic total femoropopliteal occlusions: long-term outcomes, predictors of angiographic restenosis, and role of stenting. Cardiovasc Intervent Radiol 2012;35:483-90. https://doi.org/10.1007/s00270-011-0244-5
  15. Hong SJ, Ko YG, Kim JS, Hong MK, Jang Y, Choi D. Midterm outcomes of subintimal angioplasty supported by primary proximal stenting for chronic total occlusion of the superficial femoral artery. J Endovasc Ther 2013;20:782-91. https://doi.org/10.1583/13-4398MR.1
  16. Boufi M, Azghari A, Belahda K, Loundou AD, Hartung O, Alimi YS. Subintimal recanalization plus stenting or bypass for management of claudicants with femoro-popliteal occlusions. Eur J Vasc Endovasc Surg 2013;46:347-52. https://doi.org/10.1016/j.ejvs.2013.06.003
  17. Hong SJ, Ko YG, Shin DH, et al. Outcomes of spot stenting versus long stenting after intentional subintimal approach for long chronic total occlusions of the femoropopliteal artery. JACC Cardiovasc Interv 2015;8:472-80.
  18. Tatli E, Buturak A, Kayapinar O, Dogan E, Alkan M, Gunduz Y. Subintimal angioplasty and stenting in chronic total femoropopliteal artery occlusions: early- and mid-term outcomes. Cardiol J 2015;22:115-20. https://doi.org/10.5603/CJ.a2014.0043
  19. Palena LM, Diaz-Sandoval LJ, Sultato E, et al. Feasibility and 1-Year outcomes of subintimal revascularization with $supera^{(R)}$ stenting of long femoropopliteal occlusions in critical limb ischemia. Catheter Cardiovasc Interv 2017;89:910-20. https://doi.org/10.1002/ccd.26863
  20. Ko YG, Kim JS, Choi DH, Jang Y, Shim WH. Improved technical success and midterm patency with subintimal angioplasty compared to intraluminal angioplasty in long femoropopliteal occlusions. J Endovasc Ther 2007;14:374-81. https://doi.org/10.1583/06-1983.1
  21. Antusevas A, Aleksynas N, Kaupas RS, Inciura D, Kinduris S. Comparison of results of subintimal angioplasty and percutaneous transluminal angioplasty in superficial femoral artery occlusions. Eur J Vasc Endovasc Surg 2008;36:101-6. https://doi.org/10.1016/j.ejvs.2008.02.010
  22. Soga Y, Iida O, Suzuki K, et al. Initial and 3-year results after subintimal versus intraluminal approach for long femoropopliteal occlusion treated with a self-expandable nitinol stent. J Vasc Surg 2013;58:1547-55. https://doi.org/10.1016/j.jvs.2013.05.107
  23. Ishihara T, Takahara M, Iida O, et al. Comparable 2-year restenosis rates following subintimal and intraluminal drug-eluting stent implantation for femoropopliteal chronic total occlusion. J Endovasc Ther 2016;23:889-95. https://doi.org/10.1177/1526602816666261
  24. Kim K, Ko YG, Ahn CM, et al. Clinical outcomes of subintimal vs. intraluminal revascularization approaches for long femoropopliteal occlusions in a Korean multicenter retrospective registry cohort. Circ J 2018;82:1900-7. https://doi.org/10.1253/circj.CJ-17-1464
  25. Gandini R, Fabiano S, Spano S, et al. Randomized control study of the outback LTD reentry catheter versus manual reentry for the treatment of chronic total occlusions in the superficial femoral artery. Catheter Cardiovasc Interv 2013;82:485-92. https://doi.org/10.1002/ccd.24742
  26. Bown MJ, Bolia A, Sutton AJ. Subintimal angioplasty: meta-analytical evidence of clinical utility. Eur J Vasc Endovasc Surg 2009;38:323-37. https://doi.org/10.1016/j.ejvs.2009.05.014