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Objective. To assess prospectively the first experience of subintimal angioplasty of superficial femoral artery occlusions. Patients and methods. Within a period of 36 months, 45 patients with 45 chronic occlusions in superficial femoral artery were treated at Kaunas University of Medicine Hospital. Results. The technical success rate was 84.4%, and four failures were treated by conventional surgery. The following complications occurred: one hematoma at the arterial puncture site, one artery spasm, and two distal embolizations. The mean length of occlusions was 14.2±1.4 cm. The mean ankle-brachial index improved from 0.41±0.15 to 0.81±0.04 after successful subintimal angioplasty (P&lt;0.001). Primary assisted patency rates were 94.7%, 92.1%, 84.2%, 81.6%, and 81.6% at 1, 3, 6, 12, and 24 months, respectively. The limb salvage rates were 100% and 97.8% at 1–3 and 6–12–24 months, respectively. There were no treatmentrelated amputations. Conclusions. Subintimal angioplasty of occluded superficial femoral artery is a safe and minimally invasive procedure with a high initial technical success rate, low complication rate, and good early results, and in case of failure, subsequent surgery can be performed.

Subintimal angioplasty for superficial femoral artery occlusions: first experience in Kaunas University of Medicine Hospital