3DCE-MRA对糖尿病患者下肢动脉硬化特征的研究

目的 :评价三维增强MRI血管造影(3DCE-MRA)对糖尿病(DM)患者下肢动脉硬化病变的诊断价值,并分析DM下肢动脉病变特点。方法:对47例DM(DM组)和39例非糖尿病(NDM)(NDM组)下肢动脉硬化患者行3DCE-MRA检查。以NDM组为对照,分析DM组下肢动脉病变特点。结果:DM组狭窄血管累及率为58.2%,NDM组狭窄血管累及率为42.6%,两者差异有统计学意义(P0.05)。DM组以轻中度狭窄为主,闭塞血管(9.1%)发生率较NDM组(19.9%)低(P0.05)。DM组血管狭窄主要分布在膝下中小动脉(56.5%),NDM组主要分布在膝上大血管(54.5%)。DM组膝下狭窄血管,腓动脉(15.2%)分别与腘动脉(27.2%)、胫前动脉(29.8%)、胫后动脉(27.8%)相比,差异均有统计学意义(均P0.05)。结论 :3DCE-MRA能较准确显示DM下肢动脉病变;DM下肢动脉硬化发病率较NDM高;DM更易累及膝下中小动脉,以轻中度狭窄为主,且多累及腘动脉、胫前动脉、胫后动脉。     

糖尿病与非糖尿病下肢血管病变256层CT血管造影对比研究

目的 :应用256层CT下肢血管造影比较糖尿病患者与非糖尿病患者下肢血管成像差异,探讨糖尿病下肢动脉粥样硬化样病变(lower extremities arterial disease,LEAD)发生危险因素。方法:回顾性分析180例下肢动脉病变患者的256层CTA成像结果及临床资料,其中糖尿病组(DM)90例,非糖尿病(NDM)组90例,比较2组下肢血管病变特点、一般资料、生化指标差异。结果:DM组在股深动脉、腘动脉、胫前动脉、胫后动脉、腓动脉病变率均高于NDM组(均P0.05);病变程度积分均较NDM组高(P0.05);DM组空腹血糖(FBG)、餐后2 h血糖(PBG2 h)、糖化血红蛋白(Hb A1C)、C反应蛋白(CRP)、同型半胱氨酸(Hcy)指标均高于NDM组(均P0.01)。结论:糖尿病患者下肢动脉病变较非糖尿病患者累及血管更广泛、病变程度更重。FBG、PBG2 h、Hb A1C、CRP、Hcy与糖尿病LEAD相关,CRP、Hcy可作为糖尿病LEAD的早期检测指标。     

彩色多普勒超声在糖尿病动脉硬化中的诊断价值

目的探讨彩色多普勒超声对糖尿病动脉硬化的诊断意义．并总结糖尿病患者动脉硬化的特点。方法选取80例糖尿病患者和75名健康体检者做对照研究,所有病例均使用彩色多普勒超声检查颈总动脉（CCA）、颈内动脉（ICA）、锁骨下动脉（sa）、无名动脉（IA）、股总动脉（FA）、股浅动脉（SFA）、胴动脉（PA）、足背动脉（DA）,测量动脉内径、内中膜厚度、收缩期最大流速、阻力指数、有无斑块形成及斑块的性质。结果糖尿病组CCA内径、CCA内中膜厚度、ICA内径、ICA内中膜厚度、ICA血流阻力指数、sA内径、FA内径、PA内中膜厚度等参数较健康组明显增大,2组间比较差异有统计学意义（P〈0．05）;糖尿病组CCA、SA、FA斑块的发生率明显高于健康组（P〈O．05）;动脉管壁斑块的性质,2组差异无统计学意义。结论糖尿病组血管硬化的发病率明显较高,其血管病变范围更广泛,中、小动脉也明显受累,尤以近端动脉为著;各大血管病变以后壁及血管分支处多见．较前壁有显著差异．     

2型糖尿病并缺血性脑血管疾病患者脑动脉狭窄的影像学研究

目的:利用全脑数字减影血管造影(DSA)观察2型糖尿病(病程≤5年)并缺血性脑血管疾病患者脑动脉狭窄的特点,为糖尿病并缺血性脑血管疾病的二级预防提供科学依据。方法:258例缺血性脑血管疾病患者接受计算机断层血管造影(CTA)检查,根据WHO1999年糖尿病诊断标准,分为糖尿病组(DM组)和非糖尿病组(NDM组),观察两组动脉狭窄发生率、动脉狭窄病变分布及动脉狭窄程度等内容。结果:DM组动脉狭窄发生率为76.71%,而NDM组动脉狭窄发生率为58.82%,差异显著。两组动脉病变均以多支狭窄为主,DM组多支动脉狭窄率占79.25%,而NDM组占49.00%,差异显著。两组动脉狭窄程度差异不显著。结论:糖尿病患者更易发生脑动脉狭窄,且狭窄范围更广泛、多发。病程5年之内的糖尿病并缺血性脑血管疾病动脉狭窄程度以中度狭窄为主。     

糖尿病下肢动脉硬化闭塞症64层CT血管成像分析

目的采用64层CT血管成像(CTA)探讨糖尿病患者下肢动脉硬化闭塞症的病变特点。资料与方法62例临床确诊下肢动脉硬化闭塞症的患者按照有无糖尿病合并症分为糖尿病组(DM)及单纯高血压组(HP),分别为33例和29例。使用64层螺旋CT行下肢动脉CTA检查,采用动脉造影的12分段积分法将下肢动脉分为12个节段,分析各个血管节段的斑块分布情况(斑块检出率)及斑块性质,并分别对各个节段的管腔狭窄程度进行对比分析。结果在膝以上大动脉(腘动脉及其以上血管)病变中,两组血管的斑块检出率未见统计学差异(P>0.05),且均以混合斑块为主;动脉病变狭窄程度积分DM组为左侧:6.51±3.47,右侧:6.96±3.08;HP组为左侧:4.86±2.06,右侧:5.34±2.02。两组未见统计学差异(P>0.05)。膝以下小动脉(胫前动脉发出点及其以下血管)病变中,DM组的斑块检出率明显高于HP组(P<0.05),且主要以硬斑为主,后者则以少量软斑为主;病变狭窄程度积分,DM组为左侧:7.96±3.10,右侧:8.30±2.48;HP组为左侧:3.27±1.66,右侧:3.34±1.42,两组有统计学差异(P<0.05)。结论糖尿...     

血清游离脂肪酸代谢及成分变化与2型糖尿病患者大血管并发症的关系

目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清游离脂肪酸(free fatty acid,FFA)与大血管病变的关系。方法选取河北医科大学第二附属医院2010年12月-2012年1月住院的T2DM患者173例;其中,无大血管病变T2DM 36例[A组,年龄(55.7±5.9)岁],并发1种大血管病变59例[B组,年龄(56.7±9.7)岁],并发2种大血管病变58例[C组,年龄(58.3±7.4)岁],并发3种及3种以上大血管病变20例[D组,年龄(59.8±8.9)岁]及正常对照组41例健康人[N组,年龄(54.2±7.4)岁],采用气相色谱外标定法,进行血清FFA含量和成分的测定。结果 T2DM患者总脂肪酸(total fatty acid,TFA)、饱和脂肪酸(saturated fatty acid,SFA)、多不饱和脂肪酸(polyunsaturated fatty acids,PUFA)均显著升高(P<0.05)。SFA中软脂酸(C16:0)、硬脂酸(C18:0)、二十四烷酸(C24:0)在T2DM患者中明显升高(C16:0、C18:0 P<0.01,C24:0 P<0.05)。单不饱和脂肪酸(monounsaturated fatty acid,MUFA)中油酸(C18:1)显著升高(P<0.05)。PUFA中亚油酸(C18:2)显著升高(P<0.01),二十二碳六烯酸下降明显(P<0.01)。大血管病变组组间脂肪酸成分比较,TFA、MUFA、SFA及C16:0、C18:0、C18:1在A组、B组、C组、D组中随血管病变严重程度显著升高。两两比较:C组和D组的C16:0、C18:0、C18:1及SFA、MUFA、TFA均较A组显著升高(P<0.05);C组的C18:0、D组C18:1和MUFA较B组高(P<0.05)。结论 T2DM患者体内脂肪酸成分的改变是脂代谢紊乱早期指标之一,并参与大血管病变的发生。     

微血管成像及血清HbA1c、CysC与T2DM患者下肢血管病变程度的关系

目的 探讨微血管成像及血清HbA1c、CysC与2型糖尿病(T2DM)患者下肢血管病变程度的关系。方法 选取T2DM并发下肢血管病变的70例患者，将其作为观察组，另选同期70例单纯T2DM无下肢血管病变患者作为对照组，根据泛大西洋学会联盟(TASC)制定的分级标准将观察组细分为A级组23例，B级组22例，C级组11例，D级组14例。对所有患者进行下肢股总动脉、足背动脉进行微血管成像(MVI)检测以及检测血清糖化血红蛋白(HbA1c)、胱抑素C(CysC)水平。采用Spearman相关分析股总动脉、足背动脉的MVI内径、峰值和血清HbA1c、CysC水平与T2DM患者下肢血管病变程度的关系。结果 与对照组比较，观察组股总动脉、足背动脉内径变细，连续性变差，色彩暗淡；观察组的股总动脉、足背动脉的内径、峰值均低于对照组，血清HbA1c、CysC均高于对照组，差异均具有统计学意义(P<0.05);观察组中A级组、B级组、C级组、D级组股总动脉、足背动脉的内径、峰值依次降低，HbA1c、CysC水平依次升高，差异均具有统计学意义(P<0.05);Spearman相关分析显示，股总动脉...     

3.0T磁共振CE-MRA在腹部至下肢动脉疾病中的应用价值

目的探讨3.0T超强磁场磁共振三维增强MRA(3D CE-MRA)对腹部、盆腔、下肢血管病变的诊断价值。方法使用GE EXCITEⅡ3.0T双梯度超导磁共振,对61例拟诊腹部至下肢血管病变的受检者行3D CE-MRA检查,其中36例行DSA检查。将腹部至下肢血管分为腹主动脉、髂总动脉、髂外动脉、髂内动脉、股浅动脉、股深动脉、腘动脉、胫前动脉、胫后动脉、腓动脉10个部分,由2位影像学专家独立对3D CE-MRA和DSA资料作出分析。结果61例受检者腹部至下肢血管3D CE-MRA成像均获得满意效果,血管显示清晰。8.2%(5/61)受检者未见异常,91.8%(56/61)受检者显示共计601段血管病变,其中动脉粥样斑块43.4%(261/601),动脉狭窄22.0%(132/601),动脉闭塞29.5%(177/601);动脉迂曲2.7%(16/601);动脉瘤1.5%(9/601);动脉夹层0.5%(3/601);肿瘤压迫或包绕血管0.5%(3/601)。36例3D CE-MRA与DSA比较,3D CE-MRA显示髂总动脉、髂外动脉、股浅动脉、腘动脉、腓动脉血管病变阳性检出率无差异(P>0.05),动脉粥样斑块、动脉狭窄及动脉闭塞3种血管病变显示无差异(P>0.05)。3D CE-MRA显示腹主动脉粥样斑块病变多于DSA(χ2=5.94,P=0.01),髂内动脉、股深动脉、胫前动脉、胫后动脉病变阳性检出率高于DSA(P<0.05),以DSA为标准,3D CE-MRA存在高估。结论3D CE-MRA是一种有效的评价腹部至下肢动脉疾病的方法,其诊断价值可与DSA相媲美,尤其对直径较大的腹主动脉至腘动脉主干(1~3级血管)可基本代替DSA。     

162 例糖尿病患者下肢动脉病变的特征分析

目的 研究糖尿病下肢动脉粥样硬化闭塞症的血管造影特征.方法　回顾上海交通大学医学院附属仁济医院收治的162例糖尿病下肢动脉缺血患肢造影资料.①将下肢分为髂、股、胭、小腿动脉4分段,统计患肢单节段,双节段,多节段动脉累及情况.②根据病变数目,部位,病变性质(狭窄或者闭塞),病变长度(＜5 cm,5～10 cm和＞10 cm),行分类统计.结果 根据4分段法,162条患肢中,131条为多节段动脉病变,120条患肢有股浅动脉段病变,139条患肢为小腿动脉病变.小腿动脉中,120条累及膝下2支以上动脉.分类统计有660处病变,闭塞性病变66.2%,狭窄性病变33.8%.累及小腿动脉有70.5%.超过10 cm长段闭塞病变主要分布于小腿动脉,以胫前、胫后动脉为主,腓动脉较少.152处股浅动脉病变,49处(31.2%)累及股浅动脉开口,56处(35.7%)累及内收肌管.结论 糖尿病下肢动脉病变以多平面硬化闭塞为主要表现,股浅和小腿动脉累及最多.股浅动脉病变常累及股浅动脉开口及内收肌管,股深动脉和股总动脉累及较少.小腿动脉病变以胫前、胫后动脉长段闭塞为主要表现.     

多层螺旋CT血管造影在糖尿病下肢动脉病变中的诊断价值

目的 探讨多层螺旋CT血管造影(MSCTA)在诊断糖尿病下肢动脉病变中的诊断价值.方法 对46例糖尿病下肢血管病变患者的92条下肢进行MSCTA检查,所有血管分为552个节段,重点对股浅动脉、腘动脉、胫前动脉、胫后动脉、腓动脉、足背动脉进行分析,46例中9例与血管造影对照,14例与手术对照,25例与超声检查对照研究.结果 MSCTA与血管造影符合率91.26%,与手术符合率92.13%,与超声符合率93.09%.结论 MSCTA能准确直观地显示下肢动脉的立体解剖特点,清楚显示下肢动脉狭窄、闭塞,为糖尿病下肢动脉病变的诊断和治疗提供重要依据,是糖尿病下肢动脉病变较为理想的检查方法.     

Excimer laser-assisted recanalisation of femoral arterial stenosis or occlusion caused by the use of Angio-Seal

The aim of this study was to demonstrate the effect of excimer laser and balloon angioplasty of femoral artery stenosis and occlusion after use of a haemostatic puncture closure device. A haemostatic puncture closure device (Angio-Seal) was used in 6000 patients after diagnostic or therapeutic artery catheterisation. In 34 of those patients symptoms of peripheral artery disease occurred. Sixteen of those 34 cases were transferred to our clinic for excimer laser angioplasty. All 16 patients presented with symptoms of acute peripheral artery disease within 1-14 days: superficial femoral artery (SFA) occlusions (4 cases); superficial femoral artery stenosis (3 cases); high-grade stenosis of the common femoral artery (CFA; 3 cases); high-grade stenosis of CFA; SFA and profund femoral artery (PFA; 3 cases); and occlusions of CFA, SFA and PFA (3 cases). Before any procedure was performed, informed consent was given by the patient, which included the use of the Angio-Seal closure device. Every patient who had to undergo recanalisation procedures gave additional informed consent which especially included the usage of the excimer laser for recanalisation. A measurement of the walking distance, ankle-brachial systolic pressure index (ABI) and diagnostic angiography was performed in 13 cases before and immediate after as well as 3 and 6 months after therapeutic percutaneous transluminal laser angioplasty followed by balloon angioplasty (PTLA/PTA). In 3 patients the risks of PTLA/PTA was considered too high; those patients underwent surgical repair. Angiographic and clinical improvement was achieved in 13 of 13 patients. The mean walking distance increased from 81 to > 400 m. The average ankle-brachial systolic pressure index (ABI) increased from 0.47 to 0.84. One patient developed a dissection of the SFA, and in 1 case a peripheral embolisation was seen. The PTLA/PTA technique is a successful therapeutic option for patients with femoral artery occlusion or high-grade stenosis after Angio-Seal application.     

Improvement in Claudication After Angioplasty of Distal Ostial Collateral Stenosis in Patients with Long-Segment Occlusion of the Femoral Artery

Purpose: To evaluate the angiographic and clinical effects of percutaneous transluminal angioplasty (PTA) of distal ostial collateral stenoses in patients with claudication and long-segment occlusion of the superficial femoral artery (SFA). Methods: In ten patients (9 men, 1 woman) with stable intermittent claudication due to chronic long-segment occlusion of the SFA a high-grade stenosis of the distal collateral ostium of the deep femoral artery to the popliteal artery were dilated. PTA was performed using popliteal artery access. Claudication distances on the treadmill and ankle-brachial pressure indices (ABI) at rest were analyzed before, 1 week, and 14 weeks after PTA. Results: Initial technical success was obtained in all patients. There were no significant periprocedural local complications. The initial mean claudication distance on the treadmill increased significantly from 107 ± 65 m to 306 ± 209 m (p < 0.01), the maximal claudication distance from 203 ± 128 m to 392 ± 167 m (p < 0.01). The mean ABI changed slightly but significantly (0.61 ± 0.08 vs. 0.64 ± 0.07; p < 0.05). Early follow-up after 14 weeks revealed no clinical deterioration. Conclusion: This new technique is considered helpful in patients with well-defined claudication and long-segment occlusion of the SFA.     

The “SAFARI” Technique Using Retrograde Access Via Peroneal Artery Access

The "SAFARI" technique or subintimal arterial flossing with antegrade-retrograde intervention is a method for recanalisation of chronic total occlusions (CTOs) when subintimal angioplasty fails. Retrograde access is usually obtained via the popliteal, distal anterior tibial artery (ATA)/dorsalis pedis (DP), or distal posterior tibial artery (PTA). Distal access via the peroneal artery has not been described and has a risk of continued bleeding, leading to compartment syndrome due to its deep location. We describe our experience in two patients with retrograde access via the peroneal artery and the use of balloon-assisted hemostasis for these retrograde punctures. This approach may potentially give more options for endovascular interventions in lower limb CTOs.     

Early Results of Retrograde Transpopliteal Angioplasty of Iliofemoral Lesions

Purpose: To assess whether the retrograde transpopliteal approach is a safe, practical and effective alternative to femoral puncture for percutaneous transluminal angioplasty (PTA). Methods: Forty PTAs in 38 patients were evaluated. Intentional subintimal recanalization was performed in 13 limbs. Ultrasound evaluation of the popliteal fossa was carried out 30 min and 24 hr postprocedurally in the first 10 patients to exclude local complications. All patients had a follow-up of at least 6 weeks. Results: The indication for PTA was critical ischemia in seven limbs and disabling claudication in the remainder. Stenoses (single or multiple) were present in 24 and occlusion in 15. The superficial femoral artery (SFA) was the commonest segment affected (36) followed by common femoral artery (CFA) in four and iliac artery in four. Technical success was achieved in 38 of 39 limbs where angioplasty was carried out. In one limb no lesion was found. Immediate complications were distal embolization in two and thrombosis in one. None of these required immediate surgery. There were no puncture site hematomas or popliteal arteriovenous fistulae. Symptomatic patency at 6 weeks was 85%. Further reconstructive surgery was required in three limbs and amputation in two. Conclusion: The transpopliteal approach has a high technical success rate and a low complication rate with a potential to develop into an outpatient procedure. It should be considered for flush SFA occlusions or iliac disease with tandem CFA/SFA disease where the contralateral femoral approach is often technically difficult.     

Short (1-10 cm) superficial femoral artery occlusions: results of treatment with excimer laser angioplasty

Purpose: To evaluate the safety and long-term results after laser angioplasty of short occlusions of the superficial femoral artery (SFA). Methods: In a prospective trial in 312 patients with short occlusions of the SFA excimer laser angioplasty for recanalization was applied. The average occlusion length of the SFA was 7.5 cm (range 1–10 cm). The recanalization attempt was done using either a cross-over technique from the contralateral femoral artery (278 patients), antegrade technique (16 patients) or transpopliteal technique (18 patients). Results: Percutaneous transluminal laser angioplasty (PTLA) produced successful recanalization of the SFA in 286 of 312 patients (91.7%). In 26 patients (8.3%) recanalization was not possible. The reason for the unsuccessful PTLAs was obstructing calcified materialn = 8) which was resistant to laser application. In nine cases obstructing calcifications resulted in positioning of the laser catheter in subintimal tissue or perforation of the SFA. In another four patients there was an aberrant anatomy of the SFA which resulted in a direct vessel injury after advancing the laser catheter. In five patients subintimal recanalization failed. After a follow-up period of 36 months there was a primary, primary assisted and secondary patency rate of 49.2%, 76.5% and 86.3%. Conclusion:Excimer laser angioplasty of short occlusions of the SFA is a feasible procedure with a low failure rate. Long-term results are promising but additional interventions are required in most patients to achieve a patency rate of 86.3% after 3 years. Further studies are needed to compare the clinical outcome of PTLA and PTA in short occlusions of the SFA.     

Randomized, multicenter study comparing expanded polytetrafluoroethylene-covered endoprosthesis placement with percutaneous transluminal angioplasty in the treatment of superficial femoral artery occlusive disease

PURPOSE: To compare the safety and effectiveness of the Viabahn endoprosthesis with that of percutaneous transluminal angioplasty (PTA) alone in the treatment of symptomatic peripheral arterial disease (PAD) affecting the superficial femoral artery (SFA). MATERIALS AND METHODS: From 1998 to 1999, patients with symptomatic SFA PAD were enrolled in a prospective, multicenter randomized study and underwent either PTA alone (n = 100) or PTA followed by stent-graft placement (expanded polytetrafluoroethylene/nitinol self-expanding stent-graft) (n = 97) for stenoses or occlusions of the SFA that were 13 cm long or shorter. At baseline, there were no significant differences between the PTA and stent-graft treatment groups, including chronic limb ischemia status and treated lesion length. RESULTS: The stent-graft group had a significantly higher technical success rate (95% vs 66%, P < .0001) and 1-year primary vessel patency rate at duplex ultrasonography (65% vs 40%, P = .0003). A patency benefit was seen for lesions at least 3 cm long. At 12 months, chronic limb ischemia status was 15% further improved for the stent-graft group (P = .003). There were no significant differences between treatment groups with regard to the occurrence of early or late major adverse events. CONCLUSIONS: In this multicenter study, the patency, technical success, and clinical status results obtained with stent-grafts were superior to those obtained with PTA alone.     

顺行性或逆行性改变:肌萎缩性侧索硬化的磁共振研究

目的 结合磁共振波谱成像(MRSI)、扩散张量成像技术(DTI)及MRI对肌萎缩性侧索硬化(ALS)进行对照研究,观察ALS皮质脊髓束(CST)走行区的代谢以及水分子运动的变化规律,探讨CST是否有顺、逆行性变化.资料与方法 采用MRI、MRSI及DTI技术对12例ALS患者和12名正常志愿者进行扫描,观察测量中央前回皮层下白质(SWM)、半卵圆中心(CS)、内囊后肢(PIC)、侧脑室体旁白质(PV)和大脑脚(CP)等5个CST不同解剖平面的氮-乙酰天门冬氨酸(NAA)与肌酸(Cr)比值,各向异性比(FA值)以及平均扩散率(MD值),分析比较ALS 患者和正常对照组以及不同侧别FA值、MD值以及NAA/Cr值的变化.结果 ALS的FA值较正常对照组明显降低(P＜0.001),在CST走行区的SWM、CS、PV 和 PIC平面,ALS组的FA值较正常组明显降低(P＜0.05或P＜0.01), MD值在ALS组有升高的趋势,但无统计学意义.在SWM和PV平面,ALS的NAA/Cr值较正常组降低明显(P＜0.05).FA值和MD值分别在PV和CP有左高右低的变化(P＜0.05).结论 MRSI与DTI相结合能够早期定量探测ALS患者CST的改变,左侧SWM可能为最先发生改变的区域,CST的改变可能为顺行性改变,在不同的平面改变不对称.     

Percutaneous treatment of complete chronic occlusions of the superficial femoral artery

PURPOSE: This study was done to evaluate the mid-and long-term patency rates of complete (from the origin to Hunter's duct) chronic occlusions of the superficial femoral artery (SFA) treated by angioplasty and/or stenting. MATERIALS AND METHODS: From February 2002 to March 2005, 21 patients with complete occlusion of the SFA and good distal runoff (two or three patent vessels) were treated with endovascular recanalisation. All patients had severe claudication or critical limb ischaemia. In all cases, recanalisation was performed with a contralateral approach by percutaneous transluminal angioplasty (PTA), with stenting only when PTA provided unsatisfactory results (due to elastic recoil and complications such as dissection). In the case of calcified occlusions and when the true lumen of the SFA could not be crossed, subintimal angioplasty was performed. Follow-up was done at 6 and 12 months and annually thereafter (range 6-55 months, mean 23 months) with clinical evaluation and colour-Doppler ultrasound. RESULTS: Immediate technical success was achieved in all cases (100%), with postprocedural angiography demonstrating complete recanalisation of the SFA. Two distal embolisations (9.5%) occurred, both treated successfully by local thrombolysis. Primary patency rates at 6, 12, 24, 32 and 44 months were 93.3%, 69.2%, 72.7%, 62.5% and 40%, respectively; secondary patency rates at 6, 12 and 24 months were 100%, 84.6% and 81.8%, respectively. CONCLUSIONS: Percutaneous treatment of complete chronic occlusions of the SFA showed good mid-and long-term primary patency rates, with few periprocedural complications. Reocclusions can be treated by a percutaneous technique, which ensures a good secondary patency rate.