Femoropopliteal artery chronic total occlusion intervention

Femoropopliteal (FP) artery endovascular intervention procedures are one of the most common lower extremity peripheral artery interventions (PAI) worldwide. Chronic total occlusions are highly prevalent in this vascular bed and comprise nearly 40-50% of lesions treated [1]. Intervention on FP CTO lesions is technically more challenging, is an independent predictor of procedure failure, and is associated with higher complication rates compared with non-FP CTO procedures [2]. Therefore, a systematic and step-by-step approach to such lesions, along with familiarity with various PAI tools and their attributes, is crucial to successful PAI interventional practice. In this chapter we will review a step-by-step approach to FP CTO. Given the high likelihood of tackling such lesions in clinical practice, the ability to treat FP CTO is nearly obligatory for an endovascular specialist treating patients with peripheral artery disease (PAD).