Simple Transluminal Superficial Femoral Artery Angioplasty and Stent

Background

A Transluminal superficial Femoral Artery (SFA) stent procedure is an intervention that aims to restore blood flow to the buttocks and the leg. This major artery carries blood to the whole of the leg and, therefore, narrowing of this vessel can eventually lead to serious complications whereby the leg may have to be amputated. Narrowing is usually due to atherosclerosis, a process where cholesterol deposits within the artery wall, eventually leading to blockage of the blood flow. Narrowing of the vessel can cause symptoms such as pain in the calves on walking (intermittent claudication) – you have to stop after a similar distance and rest in order to be able to walk a similar distance again. Progression of the disease can then ultimately lead to the complete occlusion of the vessel (blockage), which can result in pain at rest and loss of tissue (ulcers) on the leg. The last stage of this condition is called critical limb ischaemia.There are different options of treatment for patients with a narrowed superficial femoral artery – conservative and invasive. Every patient should be started on antiplatelet medication and statins as a best medical therapy to reduce the progression of the disease in the vessels. Also remaining active with regular exercise and trying to walk through the pain is the recommended approach. Invasive procedures are for patients with critical limb ischaemia, which include:1. Endovascular treatment – angioplasty or stenting, which is what is described in this document2. Surgical treatment - bypass surgery.Recent meta-analysis of critical limb ischaemia treatment suggests that endovascular strategy should be reserved for less fit patients with multiple comorbidities as the first line of treatment, and surgical options should be offered to the rest of patients as a first line of limb salvage treatment strategy.