Primary Retrograde Dorsalis Pedis Artery Single Access for Revascularization of Chronic Total Occlusion in Patients with Critical Limb Ischemia

Technical Success and Complication Rates of Retrograde Arterial Access for Endovascular Therapy for Critical Limb Ischaemia: A Systematic Review and Meta-Analysis

“…The six month primary patency rate (<50% stenosis) was 78% (five studies; 95% CI 46%e99%) of 78 patients 17,19,20,22,38 the six month limb salvage rate was 77% (four studies; 95% CI 70%e84%) of 158 patients, 20,22,31,39 while major amputations were required in 20% (six studies; 95% CI 11%e32%) of 360 cases during a six month follow up. 14,17,20,25,31,35,39 Two studies enrolling 54 patients reported seven minor amputations (13%). 25,36 The six month survival rate, reported by five studies, was estimated to be 91% (95% CI 80%e98%) of 345 patients.…”

“…14,20,25,31,39 During a 12 month follow up, the primary patency rate was 62% (three studies; 95% CI 25%e 93%), 18e20 the TLR rate was 33% (four studies; 95% CI 14%e55%), 13,14,18,32 the limb salvage rate was 82% (seven studies; 95% CI 67%e93%), 20,29,31,32,36,39,41 while major amputations were required in 20% (13 studies; 95% CI 13%e28%) of the patients. 13,14,17,18,20,23,25,29,31,32,36,39,41 One study investigating 40 patients reported an additional 15 minor amputations 12 months after the index procedure. 29 The 12 month survival rate reported by 11 studies was 85% (95% CI 77%e92%).…”

“…Eight studies reported on clinical improvement/symptom relief and/or wound healing during an average mean follow up of 8.0 months (SD 5.0). 17,24,30,32,34,36,38,40 Among 187 patients with available data, 129 patients experienced improvement of their symptomatic status (five studies; 81%; 95% CI 62%e96%) during follow up, 24,30,32,36,40 while 35 of 42 patients with available data, who presented with an ulcer at baseline, experienced wound healing (five studies; 95% CI 72%e96%). 17,32,34,38,40…”

Técnica PRESTO para la revascularización endovascular del segmento femoropoplíteo. Revisión de la literatura

“…La reapertura endovascular de las OTC en la AFS es un desafío técnico; se necesita una larga curva de aprendizaje y conocimiento de muchos dispositivos especiales y de recanalización con diferentes técnicas, como el cruce subintimal, abordaje transcolateral o accesos retrógrados 2 . Estos últimos constituyen una técnica para abordar oclusiones totales crónicas de la AFS después de una recanalización anterógrada fallida 3 .…”

“…Las oclusiones de la arteria femoral superficial (AFS) se tratan casi siempre por vía endovascular mediante un acceso anterógrado femoral contralateral, ipsolateral o retrógrado y al final con recanalización intraluminal o subintimal de la luz del vaso. Cuando el acceso anterógrado falla se considera una alternativa válida el acceso retrógrado [1][2][3][4] . El 20% de los intentos de recanalización endovascular por medio de acceso anterógrado falla 5,6 .…”