Refining the Antegrade Approach in Endovascular Treatment of Femoropopliteal Disease: Impact of Patient Comorbidities on Clinical and Procedural Outcomes—A Single-Center Experience

Background:Atherosclerotic peripheral artery disease (PAD) significantly affects the elderly, with intermittent claudication as its most common symptom. Superficial femoral and popliteal arteries are frequently involved, and although endovascular treatment (EVT) via an antegrade approach is increasingly favored over surgery, concerns remain about restenosis rates and its predictors.Objectives:The study aimed to determine the overall primary patency rate after EVT using the antegrade approach in patients with femoro-popliteal disease and to evaluate whether patient comorbidities and disease location influence patency rate.Methodology:A prospective study recruited 25 patients (aged 45–70) with superficial femoral or popliteal artery disease. Patients underwent EVT via an antegrade common femoral artery approach. Clinical follow-up, including clinical and duplex examinations, was performed at 3, 6, and 12 months. Results:ABI significantly improved from 0.64 ± 0.28 pre-intervention to 0.82 ± 0.27 post-intervention (p < 0.001). Primary patency rates were 92% at 3 months, 80% at 6 months, and 68% at 12 months, with no significant differences noted based on comorbidities or lesion site.Conclusions:The antegrade EVT approach is both safe and effective for femoro-popliteal disease, although further larger studies are required to confirm the lack of significant predictors of patency