Percutaneous Reconstruction Techniques: Popliteal Artery Approach for Chronic Total Occlusion of Superficial Femoral and Iliac Arteries

Abstract

Peripheral artery disease (PAD) is one of the most common diseases affecting quality of life. Claudication is the most frequent sign. If left untreated, PAD may cause serious daily life disturbances and may cause extremity losses, especially in elderly and diabetic patients. Restoration of blood flow from the aorta to the femoral arteries and from the femoral arteries to the popliteal arteries necessitates complex operational procedures. Most of these patients have concomitant coronary diseases. In such patients, open surgical repair with vascular grafts by the aid of general anesthesia increases both mortality and morbidity. Although femoral arteries are the most common site for PAD, iliac impairment is not so rare. In patients with combined iliac and femoral artery diseases, popliteal artery approach is a safe and effective technique for percutaneous revascularization. In this chapter, we share our experience with interventional percutaneous revascularization through popliteal approach, mainly using drug eluting balloons and stents, by the aid of mechanical thrombectomy devices with the highlights of current literature review.