1. Remote SFA Endarterectomy
How I Do It
David Rosenthal, MD

7. SFA (> 20 cm)
PTA
Stent LA
Atherectomy

8. “REMOTE” SFA ENDARTERECTOMY
Performed through small incision
“Debulked” arterial plaque
Endovascular stent
Durable SFA procedure?

11. Fogarty Endohelix
MollRing Cutter
Vollmar Stripper
Martin Dissector

16. BALLOON STENT ANGIOPLASTY
“TACK” DISTAL PLAQUE

17. aSpire Stent
Non-flexible Stent
aSpire Stent

19. PURPOSE
Retrospective, multicenter study was to examine the medium-term results of remote superficial femoral artery endarterectomy (RSFAE) and distal aSpire stenting.

20. STUDY GROUP (n=235) Indications for procedure: Claudication in 188
Limb Salvage in 47
All patients underwent serial duplex color-flow ultrasound scanning during follow-up.
RISK FACTORS
Percent (%)

21. RESULTS One death Wound complications in 2%
Mean length of endarterectomized SFA=28.2cm
Mean hospital LOS 1.3 days

22. RESTENOSIS (n=24) . Nine over course SFA Eight at adductor canal
Seven at distal stent
Intimal hyperplasia ? .
= 9%

23. LONG SEGMENT SFA NOT SUCCESSFULLY TREATED
Small caliber artery
Disease long & diffuse
Tortuous
Low Flow
Compression forces

24. DEBULKING SFA Increase diameter Reduce recoil & remodeling
Preserving collaterals
Durable procedure

25. CONCLUSION CONCLUSION
If RSFAE and distal aSpire stenting long-term patency rates similar to AKFP, it may prove to be minimally invasive durable adjunct for treatment of SFA occlusive disease.