OMER TANYELİ, ABDULLAH GUNER, SERKAN YİLDİRİM, YALCİN GUNERHAN, MEHMET ISİK
Turkish Journal of Vascular Surgery - 2025;34(2):109-119
Aim: We aimed to evaluate the complication status, early and mid-term success rates (after 1 year), and efficacy of rotational atherothrombectomy treatment with retrograde popliteal artery (RPA) approach in patients with total superficial femoral artery (SFA) occlusion. Material and Methods: Between 2014 and 2023, 75 patients admitted to our clinic for peripheral arterial disease (PAD) and treated with rotational atherothrombectomy using the RPA approach were retrospectively analysed. Preoperative demographic data, laboratory results, Trans-Atlantic Inter-Social Consensus (TASC) II classification and pre/post operative ankel-brachial index (ABI) values were evaluated. Patients were followed up for 1 year after treatment. Results: The mean age of 75 patients was 62.32±10.90 years and 85.3% were male. The success rate of endovascular intervention was 98.67% (74 patients). According to the preoperative TASC-II classification, 80% (60 patients) were in TASC-II C, and 20% (15 patients) were in TASCII D. Primary patency was 86.67% (65 patients) in the first month, 69.33% (52 patients) in 1-6 months and 57.33% (43 patients) in 6-12 months. Postoperative ABI values increased significantly in all patients (p<0.001). Postoperative Rutherford and Fontaine classifications were also significantly improved (p<0.001). Conclusion: The RPA approach is an effective and safe method for the treatment of complex femoropopliteal diseases. Post-treatment patency rates were 57.33% at year 1 and significant improvements were observed in postoperative claudication distance and ABI values. The retrograde popliteal artery approach can be used as a successful alternative, especially when femoral access is not possible, and this study emphasises RPA as an important part of endovascular surgery.
