Retrograde popliteal access as bail‐out strategy for challenging occlusions of the superficial femoral artery: A multicenter registry
Open Access
- 10 January 2012
- journal article
- research article
- Published by Wiley in Catheterization and Cardiovascular Interventions
- Vol. 79 (7), 1188-1193
- https://doi.org/10.1002/ccd.23361
Abstract
Background: The concomitant use of femoral and popliteal accesses has been recommended for challenging superficial femoral artery (SFA) occlusions, but no comprehensive comparison of this approach to a strategy of femoral access only is available. We thus aimed to appraise the risk‐benefit balance of retrograde popliteal access as bail‐out strategy for SFA occlusions. Methods: Consecutive patients with symptomatic SFA occlusion and undergoing percutaneous revascularization were enrolled. We distinguished patients in whom retrograde popliteal access was required as bail‐out strategy versus those not requiring such access. The primary end‐point was procedural success. Results: A total of 130 patients (152 limbs) were included, with 23 patients (25 limbs) requiring retrograde popliteal access. Occlusion length was 20.6 ± 8.8 cm in those requiring popliteal access versus 18.5 ± 8.5 cm in those without popliteal access, with TASC C/D lesions in 23 (92%) versus 106 (83%). Procedural success was achieved in 92 out of 107 patients (86.0%) treated with a standard approach and 22 out of 23 patients (95.7%) treated with retrograde popliteal access (total 114 out of 130 [87.7%]) and 112 out of 127 limbs (88.2%) and 24 out of 25 limbs (96.0%), respectively (total 136 out of 152 [89.5%]). No significant increase in early or long‐term adverse events was associated with retrograde popliteal access. Conclusions: Whenever standard access sites do not enable successful recanalization of SFA occlusions, retrograde popliteal access can be safely and effectively envisioned as bail‐out strategy.Keywords
This publication has 23 references indexed in Scilit:
- Outback Catheter for Femoropopliteal Occlusions: Immediate and Long-term ResultsJournal of Endovascular Therapy, 2011
- Retrograde percutaneous recanalization of coronary chronic total occlusions: Outcomes from 17 patientsInternational Journal of Cardiology, 2008
- Management of peripheral arterial disease patients: comparing the ACC/AHA and TASC-II guidelinesCurrent Medical Research and Opinion, 2008
- The Retrograde Coronary Approach for Chronic Total Occlusions: Mid‐Term Results and Technical Tips & TricksJournal of Interventional Cardiology, 2007
- Improved Technical Success and Midterm Patency with Subintimal Angioplasty Compared to Intraluminal Angioplasty in Long Femoropopliteal OcclusionsJournal of Endovascular Therapy, 2007
- Bypass versus angioplasty in severe ischaemia of the leg (BASIL): multicentre, randomised controlled trialThe Lancet, 2005
- Subintimal Recanalization of Long Superficial Femoral Artery Occlusions Through the Retrograde Popliteal ApproachCardioVascular and Interventional Radiology, 2001
- Retrograde femoral angioplasty: A new techniqueBritish Journal of Surgery, 1991
- Percutaneous popliteal approach for angioplasty of superficial femoral artery occlusionsCatheterization and Cardiovascular Diagnosis, 1990
- Percutaneous transluminal angioplasty of the superficial femoral artery by retrograde catheterization via the popliteal arteryCardioVascular and Interventional Radiology, 1988