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Updated: Mar 24, 2026

Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound
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Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound

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Long Femoropopliteal Lesions Challenge the Limits of Endovascular Technique: Contemporary Systematic Review and

Sameh Sayfo1, Anne M Ryschon2, Ami Sood3

  • 1Department of Interventional Cardiology, Baylor Scott & White The Heart Hospital - Plano, Plano, Texas.

Journal of the Society for Cardiovascular Angiography & Interventions
|March 23, 2026
PubMed

Insights

Endovascular treatment shows promising outcomes for long femoropopliteal lesions, offering a viable alternative to surgery. This meta-analysis provides key data on patency and revascularization rates for these complex cases.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Medical Technology

Background:

  • Femoropopliteal artery occlusive disease traditionally managed surgically.
  • Growing evidence supports endovascular treatment for long lesions.
  • Need for contemporary outcome assessment in endovascular therapy for long femoropopliteal lesions.

Purpose of the Study:

  • To systematically search and meta-analyze contemporary outcomes of endovascular treatment for long femoropopliteal lesions.
  • To assess primary patency, secondary patency, and freedom from target lesion revascularization.
  • To provide data for informed treatment decisions in complex femoropopliteal disease.

Main Methods:

  • Systematic search of Embase and MEDLINE (2000-2023).
  • Inclusion of studies with mean lesion length ≥20 cm and ≥1-year follow-up.
  • Pooled meta-analysis using random-effects model; subgroup analyses conducted.

Main Results:

  • Analysis of 28 records, 2338 limbs, and 2311 patients.
  • Pooled 12-month primary patency: 67%, secondary patency: 84%, freedom from revascularization: 79%.
  • Significant variation in event rates observed in subgroup analyses.

Conclusions:

  • Endovascular revascularization demonstrates important performance metrics for long femoropopliteal lesions.
  • Findings offer crucial insights for clinical decision-making in femoropopliteal artery disease.
  • Supports endovascular therapy as a key option for complex lesion management.
Abstract

Keywords:
TASC Dendovascularlong lesionsmeta-analysisrevascularizationsystematic search

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