Current algorithm about the endovascular treatment of femoropopliteal atheromatous lesions ?

Approach L’INTERVENTIONNEL What is your favorite approach ? Why ? Gunnar TEPE - Antegrade, easy and best control, short wires.   L’INTERVENTIONNEL Please describe what types of devices that you use to do it. G. TEPE - 5 to 6F sheath, predil, than either DCB + spot stent or DES.   L’INTERVENTIONNEL What do you think about radial approach ? G. TEPE - Not relevant for me.   Crossing L’INTERVENTIONNEL Are you a subintimal or intraluminal crossing believer ? What are the reasons ? G. TEPE - If possible intraluminal because subintimal reentry can be difficult.   L’INTERVENTIONNEL Could you describe your guidewire escalade to cross chronic total occlusion ? G. TEPE - 0.035 GW first, 0.018 or 0.014 if needed.   L’INTERVENTIONNEL How do you proceed in case of crossing failure (re-entry device? Retrograde access?) G. TEPE - Reentry device.   Vessel preparation   L’INTERVENTIONNEL What are your techniques of vessel preparation ? G. TEPE - POBA in most cases.   L’INTERVENTIONNEL How do you evaluate the quality of vessel preparation? G. TEPE - Angiography, flow.   L’INTERVENTIONNEL What are your thoughts about atherectomy, IVL or scoring balloons? G. TEPE - Not an atherectomy believer, IVL and scoring fine for vessel prep but they do not increase the patency of DCBs.   L’INTERVENTIONNEL Do you see any interest in IVUS or OCT for the SFA? G. TEPE - No real comment. In Germany no reimbursement + additional time.   Treatment L’INTERVENTIONNEL For medium length lesion, what is your strategy between DES & DCB? G. TEPE - Most cases DCB.   L’INTERVENTIONNEL For long lesions (>15cm), does it change? G. TEPE - Most cases DES.   L’INTERVENTIONNEL Do you have still any indication for bare metal stent? G. TEPE - Bail out.   L’INTERVENTIONNEL What is the place of self-expendable covered stents in your strategy? G. TEPE - Rare use.   L’INTERVENTIONNEL How do you treat re-stenosis? G. TEPE - Double dose DCB or DES.   L’INTERVENTIONNEL Any ongoing/future studies that would help clarify femoropopliteal treatment? G. TEPE - Study on treatment of high dose DCBs.   Future et perspective L’INTERVENTIONNEL What are your thoughts on Limus technologies? G. TEPE - Very early.   L’INTERVENTIONNEL BASIL BEST CLI have modified your strategy in CLTI patients? G. TEPE - No.   L’INTERVENTIONNEL Any reactions about SPORTS? G. TEPE - DES in long SFA lesions.