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Revascularization of the Femoropopliteal Artery Region

Atsushi Guntani1

  • 1Department of Vascular Surgery, Saiseikai Yahata General Hospital, Kitakyushu, Fukuoka, Japan.

Annals of Vascular Diseases
|October 3, 2024
PubMed

Insights

Endovascular therapy (EVT) is crucial for femoropopliteal artery revascularization. However, increasing EVT failures highlight the continued importance of bypass surgery for peripheral artery disease management.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Peripheral Arterial Disease Management

Background:

  • Endovascular therapy (EVT) has become a primary treatment for femoropopliteal artery disease.
  • There is a growing number of cases where EVT is not feasible or fails.
  • This necessitates a re-evaluation of traditional surgical approaches.

Purpose of the Study:

  • To provide an overview of femoropopliteal artery revascularization strategies.
  • To align current practices with the JCS/JSVS 2022 Guideline on Peripheral Arterial Disease.
  • To emphasize the role of bypass surgery in complex cases.

Main Methods:

  • Review of current literature and clinical guidelines.
  • Analysis of treatment outcomes for EVT and bypass surgery.
  • Discussion of patient selection criteria for each modality.

Main Results:

  • EVT is effective for select femoropopliteal lesions.
  • Bypass surgery remains essential for complex, long, or occluded femoropopliteal segments.
  • Guideline-directed management ensures optimal patient outcomes.

Conclusions:

  • A hybrid approach, combining EVT and bypass surgery, may be optimal.
  • Adherence to the JCS/JSVS 2022 guidelines is critical for managing peripheral arterial disease.
  • Bypass surgery's role in femoropopliteal revascularization is reaffirmed.

Keywords:
endovascular treatmentfemoropopliteal arteryprosthetic graftvein graft

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