Feasibility and outcome of endovascular management of atherosclerotic chronic total occlusion of the popliteal artery.

Background: Endovascular interventions are well-established for treating femoropopliteal diseases. However, there isstill a lack of data for isolated popliteal artery diseases.Aim: We aim to evaluate the safety, efficacy, and midterm patency of endovascular intervention for isolated poplitealartery disorders.Patients and Methods: This is a prospective nonrandomized cohort study on 23 patients presenting with critical limbischemia and subjected to revascularization at the Vascular and Endovascular Surgery Department, Kasr Elainy Hospital,Nile Health Insurance Hospital, from November 2020 to November 2022.Results: The disease involved the popliteal artery only in five (21.7%) patients. The popliteal disease was associated withinfrapopliteal disease in 18 (78.3%) patients. The P1 segment was involved in eight (34.7%) patients, the P2 segment in16 (69.5%) patients, and the P3 segment in 14 (60.8%) patients. Technical success was 100%. Lesion crossing was doneintraluminally in 18 (78.3%) cases, while subintimal angioplasty was done in five (21.7%) cases. Subintimal angioplastyhad a lower primary patency than intraluminal crossing (P=0.007). The lesion length ranged from 2 to 14 cm (mean7.59±6.4). Longer lesions (≥5 cm) were associated with lower primary patency than shorter lesions (≤4.9 cm) (P=0.048).No mortality occurred during or within 30 days of the procedure. The limb salvage rate was 93.5% during the studyperiod. Restenosis of the target lesion occurred in five patients after 6 months. The primary patency rate was 91.5% at 1month, 86.9% at 3 months, and 82.1% at 6 months.Conclusion: Endovascular intervention for popliteal artery disease in critical limb ischemia patients is a safe and effectiveprocedure that has good short-term results regarding technical success, patency, and limb salvage rates.