Retrograde Use of Frontrunner Catheter in Superficial Femoral Artery for Flushing Long Segment Occlusions Involving Distal Common Femoral Artery

Chavarria, Nelson; Kim, Tae-Hoon; Azrin, Michael; Lee, Juyong

doi:10.3400/avd.cr.16-00124

Cited by 1 publication

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References 11 publications

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“…When there is no patent stump of the SFA, antegrade ipsilateral common femoral access with dedicated catheters and wires often yields low success rates and may jeopardize the adjacent profunda femoris artery (PFA). 4 In addition, the ostium of SFA cannot be detected under angiography guidance in those cases. Adding duplex ultrasound (DUS) examination facilitates the visualization of the ostium of the flush occluded SFA and subsequent wire crossing.…”

Section: Introductionmentioning

confidence: 99%

Duplex-Guided Ipsilateral Antegrade Approach for Flush Superficial Femoral Artery Occlusion

Saleh

Ali

Gamal

et al. 2023

Vasc Endovascular Surg

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Objective Recanalization of flush ostial superficial femoral artery (SFA) occlusion is a very challenging procedure. Using the ipsilateral antegrade approach in such lesions has some difficulties. This study aimed to assess the feasibility, efficacy, and outcomes of duplex-guided ipsilateral antegrade access for endovascular treatment of atherosclerotic flush occlusion of the SFA. Methods This is a prospective two-center study that included chronic lower extremity ischemia patients with flush occlusion of SFA who underwent duplex-guided ipsilateral antegrade endovascular revascularization due to unfeasible contralateral femoral approach. Flush occlusions were preoperatively documented by duplex ultrasound and computed tomography angiography in all patients. The outcome measures were technical success, patency rates, perioperative morbidity and mortality, limb salvage, and amputation free survival rates. Results Between April 2019 and March 2021, 49 patients were enrolled in the current study with a mean age of 63.7 ± 5.7 years. Diabetes was the most common risk factor and was found in 40 (81.6%) patients. Associated popliteal lesions were found in seven (14.3%) patients, while 10 (20.4%) patients had combined tibial disease. Selective stenting was done in nine (18.4%) patients. Technical success was achieved in 43 (87.8%) patients. All failures were due to inability to cross the lesion rather than failure to access the common femoral artery. All complications were minor and occurred in seven (14.3%) patients. Primary, assisted primary, and secondary patency rates were 63.9% ± 7.1%, 82.8% ± 5.6%, and 93.5% ± 3.7% at 12 months, respectively. The overall 12-month limb salvage and amputation free survival rates were 91.8% and 83.3% ± 5.4%, respectively. Conclusion Duplex-guided ipsilateral antegrade femoral access is a feasible, safe, and effective endovascular treatment option for flush SFA occlusion when contralateral femoral access is not possible.

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Section: Introductionmentioning

confidence: 99%