Indications and Limitations of Endovascular Treatment from SVS Guidelines Superficial Femoral Artery Lesion

Abstract

Peripheral arterial disease (PAD) of the superficial femoral artery (SFA) often include complex lesions; in the past, endovascular treatment (EVT) of these lesions led to poor outcomes. Recent advances in endovascular procedures and devices have led to significant improvements, including both initial success and long-term patency. The 2015 Society for Vascular Surgery guidelines for PAD patients with claudication recommended EVT for focal SFA lesions up to 15 cm that did not involve the femoral bifurcation. Likewise, in 2017, the European Society of Cardiology recommended EVT as first-line therapy for lesions shorter than 25 cm. Currently, numerous EVT devices are available for treatment of femoropopliteal artery lesions; early and mid-term results have been reported. However, it is necessary to have a full understanding of each device and its characteristics due to several associated advantages and disadvantages. The long-term impact of any intervention must be considered, particularly for patients with claudication. The choice of intervention must be determined for each patient in accordance with the guidelines for PAD and in compliance with the instructions for use of each device.