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The Popliteal Approach: A New Approach to Percutaneous Laser-Assisted Angioplasty

Cardiovascular Institute of the South, Houma, Louisiana

Gary Chaisson

Cardiovascular Institute of the South, Houma, Louisiana

William R. Ladd

Cardiovascular Institute of the South, Houma, Louisiana

Gary Murray

Cardiovascular Institute of the South, Houma, Louisiana

Wayne Pharo

Cardiovascular Institute of the South, Houma, Louisiana

Tommy Fudge

Cardiovascular Institute of the South, Houma, Louisiana

Richard Abben

Cardiovascular Institute of the South, Houma, Louisiana

Michael A. Couvillon

Cardiovascular Institute of the South, Houma, Louisiana

David Allie

Cardiovascular Institute of the South, Houma, Louisiana

Craig M. Walker

Cardiovascular Institute of the South, Houma, Louisiana

"Hot-tip" laser angioplasty has been proven safe and effective in treating periperal vascular disease. There is, however, a group of patients with lesions or occlusions at the origin of the superficial femoral artery (SFA) that are difficult to approach from a standard antegrade femoral approach. The authors have developed a new retrograde popliteal approach that allows laser angioplasty to be performed percutaneously in these patients; 51 consecutive cases have been treated and followed up for more than one year. There were 40 cases with lesions greater than 9 cm long (Group A), while 11 cases had lesions less than 9 cm long (Group B). The mean lesion length was 15 cm. The initial success rate was 32 of 51 cases (63%): 24 of 40 cases (60%) in Group A and 8 of 11 cases (73%) in Group B proved successful. A three-month follow-up showed that clinical patency was 100% in initially successful cases (32 of 32 cases overall, 24 of 24 cases in Group A, and 8 of 8 cases in Group B). A twelve-month follow-up showed clinical patency in 20 of 32 initally successful cases (63%); 14 of 24 cases (58%) in Group A and 6 of 8 cases in Group B (75%) remained patent at twelve months.

The authors conclude that the popliteal approach to laser-assisted angioplasty is a safe and effective method of treating lesions at the origin of the SFA that could not be treated with any other percutaneous approach. One-year follow-up results in these patients are encouraging.

Vascular and Endovascular Surgery, Vol. 25, No. 1, 23-28 (1991)
DOI: 10.1177/153857449102500104


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