Twelve months follow-up after retrograde recanalization of superficial femoral artery chronic total occlusion

Abstract

IntroductionFifty percent of cases of peripheral artery disease are caused by chronic total occlusion (CTO) of the superficial femoral artery (SFA). Ten–fifteen percent of percutaneous SFA recanalization procedures are unsuccessful. In those cases the retrograde technique can increase the success rate of the procedure, but the long-term follow-up of such procedures is still unknown.AimTo assess the efficacy and clinical outcomes during long-term follow-up after retrograde recanalization of the SFA.Material and methodsWe included patients after at least one unsuccessful percutaneous antegrade recanalization of the SFA. Patients were evaluated for the procedural and clinical follow-up of mean time 13.9 months.ResultsThe study included 17 patients (7 females, 10 males) who underwent percutaneous retrograde recanalization of the SFA from June 2011 to June 2015. The mean age of patients was 63 ±7 years. Retrograde puncture of the distal SFA was successful in all cases. A retrograde procedure was performed immediately after antegrade failure in 4 (23.5%) patients and after a previously failed attempt in 13 (76.5%) patients. The procedure was successful in 15 (88.2%) patients, and unsuccessful in 2 (11.8%) patients. Periprocedural complications included 1 peripheral distal embolization (successfully treated with aspiration thrombectomy), 1 bleeding event from the puncture site and 7 puncture site hematomas. During follow-up the all-cause mortality rate was 5.8% (1 patient, non-cardiac death). The primary patency rate at 12 months was 88.2% and secondary patency 100%.ConclusionsThe retrograde SFA puncture seems to be a safe and successful technique for CTO recanalization and is associated with a low rate of perioperative and long-term follow-up complications.

Predictors of mortality and outcomes after retrograde endovascular angioplasty in patients with peripheral artery disease

“…Nevertheless, there are still scarce data on large populations that estimate the predictors of long-term treatment results in this group of patients, especially those treated from the retrograde approach. In the current study, the mortality after 36 months of follow-up was 13.4%, which was relatively low compared to previous publications, where mortality in the overall group of patients with PAD treated with endovascular interventions reached 6–50% with a similar mean age of participants to the current study at baseline and depended on the length of follow-up [13–15]. However, compared to previous studies, the rate of CKD was lower, impacting the mortality.…”

Preprocedural Mean Platelet Volume Level Is a Predictor of In-Stent Restenosis of the Superficial Femoral Artery Stents in Follow-Up

“…Endovascular treatment of the superficial femoral artery (SFA) has been successfully performed as an alternative to surgery for a long time [ 1 ]. It has been demonstrated that use of the stents in the SFA has a high procedural success and less complications [ 2 ]. Although there have been advances in the peripheral stent technology in recent times, the most important issue of the stenting is still in-stent restenosis in long-term follow-up, and its treatment is difficult [ 3 ].…”

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

“…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.…”