Dual vascular access for critical limb ischemia: Immediate and follow‐up results

Abstract

Dual vascular access was successfully used in a small number of selected patients and this technique may hold promise in improving the success rates in the treatment of complex popliteal and infrapopliteal occlusions.

Ultrasonography-guided retrograde tibial artery puncture for recanalization of complex infrainguinal arterial occlusions

“…It was assumed that the distal portion of an occluded vessel is less fibrotic or contains less calcified tissue and allows for easier passage of a guidewire into the occlusion (15,16). The rationale behind the retrograde recanalization was that the guidewire could easily pass into the true lumen when advanced from the retrograde access artery.…”

“…We did not use the snare-kit to advance the guidewire into the proximal access, as these may take time and may make the procedure more complex. Yeh et al (15) used a tibial access sheath without the retrograde balloon. They did not use a snare-kit to extract the retrograde guidewire.…”

Predictors of adverse clinical outcomes after successful infrapopliteal intervention

“…When a penetration technique was needed, a CTO‐dedicated 0.014‐ and/or 0.018‐inch guide wire were used. Novel techniques were applied in case of failed reentry from the subintimal space to true lumen in 9.4% (10 cases) as follows; a retrograde pedal or tibial approach was used in eight cases, transpedal approach in one case, and transcollateral in one case [6, 10]. Besides the over‐the‐wire 2.0–3.0 × 20–100 mm 2 balloon, a rapid‐exchange 1.25–2.5 × 10–40 mm 2 balloon was used for balloon angioplasty.…”

Bidirectional endovascular treatment for chronic total occlusive lesions of the femoropopliteal arterial segment using a hand-carried ultrasound device and a retrograde microcatheter

“…11,14 Even though the retrograde approach from the popliteal artery or tibial artery is useful for CTO of the femoropopliteal arterial segment, procedurally related complications, including huge hematoma and pseudoaneurysm, are reported to occur at a frequency of ϳ5%. 5 These complications are often correlated with puncture using a sheath of Ͼ4F.…”