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study was to evaluate the technical success of the percutaneous retrograde access procedure after failed antegrad recanalization in Thromboangiitis Obliterans (Buerger's Disease) patients. Method(s): Thirteen consecutive patients (12 men, 1 women, mean age: 40.3 ± 5.6 years) and 14 arteries underwent retrograde puncture for recanalization with a diagnosis of TAO (Thromboangiitis Obliterans), between April 2015 and December 2018. After unsuccessful attempts using the antegrade approach, retrograde puncture were used under ultrasound and fluoroscopic guidance. Ipsilateral retrograde access was attempted in three patients with SFA (superficial femoral artery) in three patients with PTA (posterior tibial artery), in two patients with PEA (peroneal artery) and in five patients ATA (anterior tibial artery). The primary purpose of the study was to evaluate the technical success of the procedure in obtaining the ability to pass the wire across target artery and providing blood flow to the below the knee arteries. Result(s): Technical success was achieved 12 of 13 arteries (92.3%). In a patient who underwent PTA puncture, the retrograde approach failed because the guidewire could not be passed through the occlusive artery. There were no major complications in any of the cases. Conclusion(s): Endovascular treatment is a technically feasible and potentially effective treatment modality for Buerger's disease. Retrograde interventions in TAO patients may improve technical success and clinical improvement, especially in cases where antegrade approach fails.

The purpose of the study was to evaluate radiation exposure during varicocele embolization and correlate it with access site, embolized side, and complexity of varicoceles. Materials and Methods: This retrospective study included 39 adults who underwent varicocele embolization with a combination of coils and sclerosing agents between January 2015 and December 2018. Left-sided embolization was done in 26 patients and bilateral embolization in 13 patients. Jugular access was used in ten patients, whereas upper limb access was done in 29 patients. Dose area product (DAP) and total fluoroscopy time were collected and correlated to the treated side, access site, and complexity of varicoceles. Results: The mean fluoroscopy time for left varicocele embolization was 26.76 min, which was not statistically different (P = 0.16) compared to bilateral embolization (33.2 min). There was no statistical difference (P = 0.37) between the mean DAP for left embolization of 106,239 mGy.cm² compared to bilateral DAP of 107,153 mGy.cm². There was no difference in the mean DAP or fluoroscopy time between jugular vein access (DAP = 87,569 mGy. cm², time = 34 min) and upper limb venous access (DAP = 113,086.8534 mGy.cm², time = 28 min) with P = 0.64 and P = 0.14, respectively. There was no statistically significant correlation between the left varicocele Bähren classification and the fluoroscopy time (P = 0.52) or DAP (P = 0.76). Conclusion: This study finds no significant difference in DAP or fluoroscopy time between jugular and upper limb venous access or between left and bilateral embolization.