Retrograde Popliteal Access for Challenging Superficial Femoral Artery Occlusion.
Georges IbrahimSami NabhaniMichel FeghalyPublished in: International journal of vascular medicine (2021)
Retrograde popliteal access has long been established as an alternative to the antegrade approach to occlusive lesions in the superficial femoral artery (SFA). However, early reports with high complication rates (dissection, hematomas, aneurysms, and arteriovenous shunts at the puncture site) reduced enthusiasm for this technique. In recent years, with the development of thinner sheaths and low profile angioplasty devices, retrograde popliteal access has resurfaced as a viable technique, mostly in combination with or after failure of the more classical antegrade approach. In this retrospective study, we will report the safety and efficacy of the retrograde popliteal approach in the treatment of superficial femoral artery chronic total occlusions, in 13 consecutive patients between January 2017 and January 2021. The results showed 100% successful puncture of the popliteal artery and 100% successful recanalization and stenting of the superficial femoral artery with a total of 2 complications related to the puncture site and zero periprocedural mortality. In conclusion, the retrograde popliteal approach appears to be an effective and safe alternative to the common SFA complete total occlusion (CTO) treatment approach.
Keyphrases
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- ultrasound guided
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- risk factors
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- chronic kidney disease
- percutaneous coronary intervention
- cardiovascular disease
- prognostic factors
- combination therapy
- coronary artery disease
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- antiplatelet therapy
- replacement therapy
- atrial fibrillation
- patient reported
- direct oral anticoagulants
- sickle cell disease