Integrated application of antegrade and retrograde recanalization for femoral-popliteal artery chronic total occlusions: outcomes compared with antegrade recanalization

Wei, Liming; Zhang, Donghui; Zhang, Peilei; Lü, Haitao; Zhao, Juping

doi:10.21037/qims.2018.07.02

Cited by 5 publications

(2 citation statements)

References 18 publications

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“…5 The use of a retrograde approach in recanalization of atherosclerotic occlusions has already been reported in the treatment of occlusions of the superior femoral artery after the failure of the ipsi-or contralateral femoral approach. 12,13 Indeed, histopathological features of atherosclerotic occlusions suggest a more favorable condition in the retrograde recanalization. Atherosclerotic occlusions often have a proximal fibrous cape with a tapered convex shape, pushing the guidewire peripherally into the subintimal space.…”

Section: Discussionmentioning

confidence: 99%

Retrograde Recanalization of the Celiac Artery via the Pancreaticoduodenal Arcade as a Safe and Valid Alternative to Antegrade Access

Pedersoli

Zimmermann

Schulze-Hagen

et al. 2020

Vasc Endovascular Surg

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Purpose: The antegrade recanalization of an occlusion or high-grade stenosis of the celiac artery via the aorta often represents a technical challenge. A retrograde approach via the superior mesenteric artery and the pancreaticoduodenal arcade may be an alternative approach. Based on our experience, we assess the technical success and the short- and mid-term outcomes of this bailout procedure. Methods: We performed a retrospective analysis of all consecutive patients who underwent recanalization and stent implantation in the celiac artery between January 2010 and December 2018. Data on vascular access, the materials used including stents, as well as the length of the intervention, radiation exposure, and follow-up were assessed. Results: Recanalization in combination with stent implantation into the celiac artery was performed in 43 patients. In 39 (91%) of 43 patients, the recanalization was successful with an antegrade approach via the aorta, whereas in 4 (9%) of 43 patients the passage of the stenosis was possible only through a retrograde approach through the superior mesenteric artery and the pancreaticoduodenal arcade followed be advancement of the microwire through the celiac artery into the aorta. The tip of the microwire was captured in the aorta with a snare and pulled out in the femoral introducer sheath and used as a guide for the antegrade implantation of a balloon-expandable stent. Conclusions: The retrograde recanalization of the celiac artery via the pancreaticoduodenal arcade may be technically challenging yet represents a feasible alternative in case of a failed antegrade approach.

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Section: Discussionmentioning

confidence: 99%

Retrograde Recanalization of the Celiac Artery via the Pancreaticoduodenal Arcade as a Safe and Valid Alternative to Antegrade Access

Pedersoli

Zimmermann

Schulze-Hagen

et al. 2020

Vasc Endovascular Surg

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“…Concerning the definition of chronic total occlusions of femoropoliteal artery, its long, diffuse, and even total occlusions often requires EVT. The antegrade approach is a preferable choice when we underwent the SFA intervention, and this procedure is performed using a contralateral retrograde of the femoral artery or an ipsilateral antegrade puncture [8] . The popliteal approach is often used as an alternatively plan when these above approaches are unfavorable or unsuccessful.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment for chronic total occlusion of superficial femoral artery: Is retrograde approach from popliteal artery effective and safe?

Lam

Phan

Sơn

et al. 2020

Radiology Case Reports

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A 55-year-old male was admitted with numbness in the left foot and intermittent claudication. Doppler ultrasound and digital subtraction angiography presented chronic total occlusion in the ostial of left superficial femoral artery and reperfusion flow at one-third below from collateral channels of deep femoral artery. Thus, we decided to perform an endovascular intervention for this patient. First, we used contralateral transfemoral approach technique, but the microwire could not reach to the occluded superficial femoral artery lesion. Then, we approached the chronic total occlusion lesion retrogradely. A wire was passed successfully from the popliteal artery to ostial superficial femoral artery. Finally, 2 stents were implanted. This case highlights that popliteal retrograde approach is effective and safe for total occlusion of superficial femoral artery.

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The “Pull, Cast, and Fix” Technique for Bypass in the Midpopliteal (P2) Arterial Segment in Chronic Femoropopliteal Occlusions

Georgakarakos

Tasopoulou

Koutsoumpelis

et al. 2021

Annals of Vascular Surgery

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Integrated application of antegrade and retrograde recanalization for femoral-popliteal artery chronic total occlusions: outcomes compared with antegrade recanalization

Abstract: Retrograde recanalization is effective for CTO of femoral-popliteal artery after the failure of an antegrade procedure; immediate outcomes and mid-term patency and limb salvage rate are comparable with that of antegrade procedure.

Cited by 5 publications

References 18 publications

Retrograde Recanalization of the Celiac Artery via the Pancreaticoduodenal Arcade as a Safe and Valid Alternative to Antegrade Access

Retrograde Recanalization of the Celiac Artery via the Pancreaticoduodenal Arcade as a Safe and Valid Alternative to Antegrade Access

Endovascular treatment for chronic total occlusion of superficial femoral artery: Is retrograde approach from popliteal artery effective and safe?

The “Pull, Cast, and Fix” Technique for Bypass in the Midpopliteal (P2) Arterial Segment in Chronic Femoropopliteal Occlusions

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