Percutaneous Direct Puncture of Occluded Superficial Femoral Artery in Buerger's Disease

Abstract

Purpose:The purpose is to to describe the relatively rare involvement of the superficial femoral artery (SFA) in Buerger's disease and the direct puncture technique used in complete occlusion.Materials and Methods:The study included patients with Buerger's disease who underwent endovascular treatment for lower extremity ischemic symptoms over a 6-year period. Patients with occluded SFA who required direct access to the occluded vessel were included. Primary and secondary patency rates and Rutherford scores before and after the procedure were evaluated.Results:Among 44 limbs, 54 interventions of 39 patients with Buerger's disease were analyzed. SFA involvement, the ultrasound-guided direct puncture technique was applied to the occluded SFA in five patients after unsuccessful attempts with antegrade and retrograde techniques. Primary patency was achieved in four of these five patients, while one patient could not achieve primary patency due to the inability to establish flow in the popliteal artery. Rutherford scores significantly decreased in all patients.Conclusions:Contrary to previous knowledge, the SFA can also be affected in Buerger's disease. In cases of complete occlusion, the success of the procedure can be improved using the direct puncture technique to access the occluded vessel under ultrasound guidance.