Abstract:

A literature review is devoted to endovascular treatment of occlusive and stenotic lesions in arteries of femoral-popliteal segment.

Currently, 2-3% of the RF population suffer from atherosclerotic lesions of arteries of lower limbs. In the structure of cardiovascular disease, atherosclerosis of lower limbs has the level about 20%. In 82% the cause of vascular disease is atherosclerosis. In the structure of atherosclerotic arterial disease of lower limbs more often (47% to 65%) occurs defeat of the femoral-popliteal segment particularly in patients older than 60 years; that is confirmed by numerous statistical observations. The aim of the article was to compare results of endovascular treatment of arterial lesions of the femoral-popliteal segment.

This article presents results of a solo balloon angioplasty, balloon angioplasty with drug-eluting balloons, subintimal angioplasty, stenting drug-eluting and bare-metal stents, cryo-plastics,catheter atherectomy, hybrid interventions and compare results of open and endovascular interventions. Data of STAR register, published in 2001, show that the correction of lesions category C, TASC II, using balloon angioplasty is quite possible to count on similar results in category B.

According to Conrad M. et.al, Amato B. et.al and Dey C., despite the high incidence of the primary success of endovascular interventions for femoral-popliteal segment long-term results often look depressing.

Great importance is given to study the possibility of the use of drug-eluting stents, which have proven effectiveness in suppressing the inflammatory response and intimal hyperplasia after stenting of coronary arteries, as evidenced by research SIROCCO, SIROCCO II, STRIDES, Zilver PTX. Thus, the use of drug-eluting stents in the femoral-popliteal segment did not reduce the frequency of restenosis.

THUNDER, FemPac and LEVANT researches indicate that drug-eluting balloons provide some benefits that are absent in other endovascular techniques such as solo balloon angioplasty and stenting.

The final stage of a multicenter randomized trial BASIL, which carried out a comparative analysis of FPB and PTA groups, was reached in 2010. As a result, the preservation of limbs and survival did not differ significantly

Thus, the literature report reveals a clear tendency of domination of endovascular strategies in defeated limb blood-flow recovery Minimally invasive balloon angioplasty and stenting compared with results of bypass operations, reconstructions - is not worse and consider endovascular treatment strategy in the surgical treatment of femoral-popliteal segment to be method of first choice. 

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