What are the ESC/ESVS guidelines for revascularization of femoropopliteal occlusive lesions?

Updated: Sep 12, 2019
  • Author: Josefina A Dominguez, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
  • Print
Answer

Recommendations for revascularization of femoropopliteal occlusive lesions in patients with intermittent claudication and severe chronic limb ischemia are as follows:

  • Endovascular-first strategy is recommended in short (< 25 cm) lesions (class I recommendation; evidence level C)
  • Primary stent implantation should be considered in short (< 25 cm) lesions (class IIa recommendation; evidence level A)
  • Drug-eluting balloons may be considered in short (< 25 cm) lesions (class IIb recommendation; evidence level A)
  • Drug-eluting stents may be considered for short (< 25 cm) lesions (class IIb recommendation; evidence level B)
  • Drug-eluting balloons may be considered for treatment of in-stent restenosis (class IIb recommendation; evidence level B)
  • In patients not at high risk for surgery, bypass surgery is indicated for long (≥25 cm) SFA lesions when an autologous vein is available and life expectancy is >2 years (class I recommendation; evidence level B)
  • The autologous saphenous vein is the conduit of choice for femoropopliteal bypass (class I recommendation; evidence level A)
  • When above-the-knee bypass is indicated, the use of a prosthetic conduit should be considered in the absence of any autologous saphenous vein (class IIa recommendation; evidence level A)
  • In patients unfit for surgery, endovascular therapy may be considered in long (≥25 cm) femoropopliteal lesions (class IIb recommendation; evidence level C)

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!