Treatment
10
Table 8. Intervention For Femoropopliteal Occlusive Disease
(FPOD) in Intermittent Claudication
Recommendations Grade
Level of
Evidence
The SVS recommends endovascular procedures over open
surgery for focal occlusive disease of the superficial femoral
artery (SFA) artery not involving the origin at the femoral
bifurcation.
1 C
For focal lesions (<5 cm) in the SFA that have unsatisfactory
technical results with balloon angioplasty, the SVS suggests
selective stenting.
2 C
For intermediate-length lesions (5–15 cm) in the SFA,
the SVS recommends the adjunctive use of self-expanding
nitinol stents (with or without paclitaxel) to improve the
midterm patency of angioplasty.
1 B
The SVS suggests the use of preoperative ultrasound
vein mapping to establish the availability and quality of
autogenous vein conduit in patients being considered for
infrainguinal bypass for the treatment of IC.
2 C
The SVS recommends against EVT of isolated infrapopliteal
disease for IC because this treatment is of unproven benefit
and possibly harmful.
1 C
The SVS recommends surgical bypass as an initial
revascularization strateg y for patients with diffuse
femoropopliteal (FP) disease, small caliber (<5 mm), or
extensive calcification of the SFA, if they have favorable
anatomy for bypass (popliteal artery target, good runoff )
and have average or low operative risk.
1 B
The SVS recommends using the saphenous vein as the
preferred conduit for infrainguinal bypass grafts.
1 A
In the absence of a suitable vein, the SVS suggests using
prosthetic conduit for FP bypass in claudicant patients if
the above-knee popliteal artery is the target vessel and good
runoff is present.
2 C
