CASE 491 Published on 09.08.2000

PTA of distal superficial femoral artery lesions

Section

Interventional radiology

Case Type

Clinical Cases

Authors

D.Vorwerk

Patient

72 years, female

Clinical History
Successful angioplasty of distal sfa/ proximal popliteal lesions
Imaging Findings
The diabetic patient was referred for non healing ulcer of the left foot (Stage IV Fontaine). Stage IV disease was present for 6 weeks.There was no history of tobacco smoking or other known risks for atherosclerosis besides diabetes. No peripheral pulses were palpable on the same limb.Angiography revealed multiple stenoses of the distal superficial femoral artery (SFA) and the proximal popliteal artery (Fig. 1 a,b). In addition, heavily diseased lower-limb arteries were found not showing lesions which were prone to percutaneous treatment. After passage of the diseased segment by use of a coated guidewire and a catheter, a noncoated 0.035 in guidewire was inserted through the multipurpose catheter which was exchanged for a 4 mm wide 4 cm long balloon catheter. After dilation over 45 seconds for each lesion, the postangioplasty result was considered satisfactory. During follow-up, the ulcer healed completely within 10 days.
Discussion
Balloon angioplasty is indicated if short stenotic lesions are present. Especially in stage IV (Fontaine) PTA is recommendable to solve the immediate problem of endangered limb salvage. If possible recanilzation of all obstructed vascular segments should be obtained. In that particular case, however, recanalization of the lower limb arteries was not feasible. Long-term results in femoral PTA is limited and is not dramatically improved by use of stents. That is, why stents cannot be recommended as a regular approach to improve PTA results in that region.
Differential Diagnosis List
Successful PTA of a distal femoral/ proximal popliteal arterial stenoses in stage IV disease
Final Diagnosis
Successful PTA of a distal femoral/ proximal popliteal arterial stenoses in stage IV disease
Case information
URL: https://eurorad.org/case/491
DOI: 10.1594/EURORAD/CASE.491
ISSN: 1563-4086