Retrograde Deep Femoral Artery Access as Bailout Technique to Rescue Unexpected Ostial Occlusion during Antegrade Superficial Femoral Artery Recanalization.
Journal
Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
15
11
2019
revised:
15
12
2019
accepted:
17
12
2019
pubmed:
11
1
2020
medline:
21
10
2020
entrez:
11
1
2020
Statut:
ppublish
Résumé
We report a case of deep femoral artery (DFA) retrograde access for recanalization of an accidental ostial occlusion complicating an antegrade-retrograde superficial femoral artery (SFA) procedure. A 77-year-old man with chronic limb-threatening ischemia of the right lower limb was submitted to a duplex ultrasound that showed a heavy calcified SFA chronic total occlusion. During antegrade and retrograde attempts to cross the SFA obstruction, a control angiogram unexpectedly showed the ostial occlusion of the DFA. Several antegrade attempts to cross the DFA occlusion with various guidewires and catheters were unsuccessfully made. Retrograde access was achieved by direct puncture of the DFA distally to the first perforating artery. With sheathless approach, the occlusion was crossed, the retrograde guidewire was externalized through the femoral sheath, and the balloon angioplasty was then performed antegradely. The SFA recanalization was interrupted because of patient discomfort. The patient had an uncomplicated recovery, with immediate resolution of rest pain probably because of the resolution of the underestimated DFA stenosis. The retrograde DFA access is a useful bailout technique in case of accidental ostial occlusion of the DFA.
Identifiants
pubmed: 31923596
pii: S0890-5096(20)30018-2
doi: 10.1016/j.avsg.2019.12.041
pii:
doi:
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
666.e7-666.e10Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.