Endovascular Treatment Versus Surgery in Long Occlusions of the Superficial Femoral Artery about 50 Cases

Surgical treatment is considered the gold standard for the management of complex lesions in FSA and is currently in competition with the improvement of new endovascular techniques. The aim of this work is to compare the two revascularization techniques in terms of efficacy, morbidity and mortality, which is based on a retrospective study of 50 cases of long FSA occlusions treated either by surgical treatment or by endovascular, at the vascular surgery department of Avicenna military hospital in Marrakech during the period between January 2014 to December 2016. The mean age of our patients was higher in the endovascular treatment group compared to the surgical treatment group, (68.5 years versus 62.3) respectively, we noted a male predominance in both groups. Critical lower extremity ischaemia was the most common reason for consultation in both groups: 76.7% in the endovascular treatment group and 80% in the surgical treatment group. All the patients had received the necessary explorations to assess the lesion as well as the extension of the atherosclerotic disease. The technique was successful in 100% of cases, without any major postoperative complications or death, the average length of hospital stay was lower in the endovascular treatment group: one day compared to 4 days in the surgical treatment group. The primary and secondary patency at 12 months were similar in the two groups (73.3% versus 75%) and (83.3% versus 85%) respectively. Thanks to the improvement of endovascular techniques, the management of long occlusions of the superficial femoral artery therefore appears to be an attractive alternative to surgical treatment, more particularly for patients with high surgical risk and presenting numerous comorbidities.