Retrograde Pedal Access Technique for Revascularization of Infrainguinal Arterial Occlusive Disease

Sabri, Saher S.; Hendricks, N.; Stone, James L.; Tracci, Megan C.; Matsumoto, Alan H.; Angle, John F.

doi:10.1016/j.jvir.2014.10.008

Cited by 35 publications

(34 citation statements)

References 32 publications

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“…In contrast to our experience, Mustapha et al reported the main reason for failure as access site calcification and consecutive inability to puncture the crural or pedal vessel [20]. Sabri et al reported both an inability to access the pedal vessel and failure to achieve re-entry following retrograde subintimal passing of the lesion as the main reasons for procedural failure [19]. So far, the literature regarding retrograde transpedal revascularization procedures is limited and to some degree inhomogeneous.…”

contrasting

confidence: 77%

“…Other groups, however, reported limb salvage rates at 12 months between 64 % and 82.3 % after retrograde pedal access interventions [1,5,19]. Although femoral and popliteal occlusions were included in these studies, the reported limb salvage of 72.9 % in our study compares favorably with these results.…”

supporting

confidence: 73%

“…In this context a retrograde approach was already described 25 years ago by surgeons who performed a cut-down of the posterior tibial artery [18]. Results after a percutaneous retrograde approach have recently been published with promising results regarding technical success and clinical outcomes [9,11,19,20]. In the meantime a dedicated pedal access set has become commercially available.…”

mentioning

confidence: 99%

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Retrograde Transpedal Access for Revascularization of Below-the-Knee Arteries in Patients with Critical Limb Ischemia after an Unsuccessful Antegrade Transfemoral Approach

Goltz

Planert

Horn

et al. 2016

Fortschr Röntgenstr

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Interventional Radiology 940Goltz JP et al. Materials and Methods:We retrospectively identified 16/172 patients (9.3 %) with endovascular BTK revascularization in whom a transfemoral approach had failed and transpedal access had been attempted. The dorsal pedal (n = 13) or posterior tibial (n = 3) artery was accessed using a dedicated access set and ultrasound guidance. The procedure was finished in antegrade fashion by plain old balloon angioplasty (POBA). Comorbidities, vessel diameter and calcification at the access site were recorded. The analyzed outcomes were technical success, procedural complications, procedure time, crossing (guidewire beyond lesion and intra-luminal) and procedural (residual stenosis < 30 % after POBA) success, and limb salvage. Results: Diabetes, coronary artery disease and hypertension were present in 15 patients (93.8 %), and both renal impairment and previous amputations in 7 (43.8 %). Pedal access vessel calcification was present in 5/16 patients (31.3 %). The mean diameter was 1.75 +/-0.24 mm. The procedure time was 92.4 +/-23 min. The success rate for achieving retrograde access was 100 %. Retrograde crossing was successful in 12/16 patients (75.0 %). Procedural success was observed in 10/16 patients (68.8 %). Minor complications occurred in 2/16 patients (12.5 %). The rate of limb salvage was 72.9 %, and the overall survival was 100 % at 12 months. Major amputations after revascularization occurred in 2/16 patients (12.5 %). Conclusion: If an antegrade transfemoral approach to BTK lesions fails, a retrograde transpedal approach may nevertheless facilitate treatment. This approach appears to be safe and offers high technical and acceptable clinical success rates.This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

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contrasting

confidence: 77%

supporting

confidence: 73%

mentioning

confidence: 99%

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Retrograde Transpedal Access for Revascularization of Below-the-Knee Arteries in Patients with Critical Limb Ischemia after an Unsuccessful Antegrade Transfemoral Approach

Goltz

Planert

Horn

et al. 2016

Fortschr Röntgenstr

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“…introduced subintimal arterial flossing with antegrade–retrograde intervention (SAFARI) technique. By combining an antegrade and retrograde approach, the success rate is around 90% 3 . Here, a hybrid Viabahn-assisted bypass (VAB) technique is described, which combines localized open surgery and the SAFARI technique for true lumen re-entry in difficult cases.…”

Section: Introductionmentioning

confidence: 99%

A Novel Hybrid Viabahn-assisted Bypass Technique: Extra-arterial Flossing Wiring for Chronic Total Occlusion in Superficial Femoral Artery

Lin

Chen

2016

EJVES Short Reports

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IntroductionA hybrid Viabahn-assisted bypass (VAB) technique is introduced for revascularizing chronic total occlusion (CTO) in superficial femoral artery (SFA) when bypass surgery is difficult or endovascular intervention fails.ReportThis technique combines extra-arterial flossing wiring with antegrade-retrograde intervention via traditional open exposure of middle SFA and deploying a Viabahn from the proximal true lumen through the subintimal lumen and extra-arterial space, and back into distal true lumen to restore flow. It only needs a 3–5 cm incision to expose the mid-SFA without clamping or endarterectomy of the SFA.DiscussionThis hybrid procedure is an alternative technique to improve SFA revascularization in some difficult CTOs.

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“…Tibiopedal access, which has been described previously, has been shown to result in a high rate of technical success. 5 When an antegrade approach to reestablish in-line flow to an ischemic limb fails, a familiarity with retrograde tibiopedal access and crossing techniques is an essential component of the interventionalist's armamentarium to aid healing, prevent amputation, and improve patient symptoms.…”

Section: Introductionmentioning

confidence: 99%

Retrograde Tibiopedal Access for the Treatment of Critical Limb Ischemia

Dobrow

Mittleider²

2015

Techniques in Vascular and Interventional Radiology

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Retrograde Pedal Access Technique for Revascularization of Infrainguinal Arterial Occlusive Disease

Cited by 35 publications

References 32 publications

Retrograde Transpedal Access for Revascularization of Below-the-Knee Arteries in Patients with Critical Limb Ischemia after an Unsuccessful Antegrade Transfemoral Approach

Retrograde Transpedal Access for Revascularization of Below-the-Knee Arteries in Patients with Critical Limb Ischemia after an Unsuccessful Antegrade Transfemoral Approach

A Novel Hybrid Viabahn-assisted Bypass Technique: Extra-arterial Flossing Wiring for Chronic Total Occlusion in Superficial Femoral Artery

Retrograde Tibiopedal Access for the Treatment of Critical Limb Ischemia

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