Department of Vascular Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands.
Medicina (Kaunas). 2022 Jul 20;58(7):961. doi: 10.3390/medicina58070961.
Report of a successful case of endovascular recanalization of an occluded superficial femoral artery (SFA) using Fiber Optic RealShape (FORS) technology.
A 79-year-old male was referred for evaluation of multiple ischemic pretibial ulcers of the right lower extremity. Computed tomography-angiography (CTA) imaging confirmed significant stenosis of the right common femoral artery (CFA) and an occlusion of the SFA from its origin to the Hunter's canal. The patient was treated with a hybrid surgical procedure: an endarterectomy of the CFA and SFA origin was performed combined with an endovascular recanalization of the occluded SFA using FORS technology. During recanalization, the FORS guidewire slowly twisted subintimally around the occluded lumen of the SFA, maintaining the created corkscrew shape after pre-dilation with the percutaneous transluminal angioplasty (PTA) balloon and subsequent stenting.
FORS technology can be successfully used during recanalization of an occluded SFA without the use of fluoroscopy. The corkscrew shape formed during recanalization in this case was retained during PTA balloon pre-dilation and stenting; this potentially improves hemodynamics and thereby reduces the risk of in-stent restenosis. However, expanding patient series and longer follow-up data are needed to increase the understanding of the feasibility and effectiveness of using FORS in the treatment of peripheral arterial occlusive disease.
报告一例使用 Fiber Optic RealShape（FORS）技术成功治疗闭塞性股浅动脉（SFA）的病例。
一名 79 岁男性因右下肢多处缺血性小腿前溃疡就诊。计算机断层血管造影（CTA）成像证实右侧股总动脉（CFA）明显狭窄，以及 SFA 从起点到 Hunter 管的闭塞。患者接受了一种混合手术治疗：行 CFA 和 SFA 起点的内膜切除术，并结合 FORS 技术对闭塞的 SFA 进行血管内再通。在再通过程中，FORS 导丝在 SFA 的闭塞管腔中缓慢地进行皮下扭曲，在经皮腔内血管成形术（PTA）球囊预扩张和随后的支架置入后保持形成的螺旋形状。
在不使用透视的情况下，FORS 技术可成功用于再通闭塞的 SFA。在本病例中，再通过程中形成的螺旋形状在 PTA 球囊预扩张和支架置入过程中得以保留；这可能改善血液动力学，从而降低支架内再狭窄的风险。然而，需要扩大患者系列并增加更长时间的随访数据，以增加对使用 FORS 治疗外周动脉闭塞性疾病的可行性和有效性的理解。
