Popliteal Versus Tibial Retrograde Access for Subintimal Arterial Flossing with Antegrade–Retrograde Intervention (SAFARI) Technique

Abstract

The SAFARI technique is a safe and feasible option for patients with infrainguinal CTO (TASC II C and D). The PT or DP as the retrograde access after surgical vessel exposure is a good choice when using the SAFARI technique.

Retrograde Transpopliteal Access Is Safe and Effective—It Should Be Added to the Vascular Surgeon's Portfolio

“…In 2 studies of retrograde revascularizations, Sheinert et al and Hua et al also demonstrated that a retrograde approach was safe. 3,4 Our procedural success rate of 94% compares favorably with a study by Sangiorgi et al 7 of 23 patients (25 limbs) requiring retrograde popliteal access for occlusive lesions with an average length of 20.6 ± 8.8 cm. This group demonstrated procedural success in 22 of 23 patients.…”

Outcomes at a single center after subintimal arterial flossing with antegrade-retrograde intervention for critical limb ischemia

“…Although a large number of studies do not report on limb salvage rate, Hua et al 5 described a 1-year limb salvage rate of 80%, similar to the results published by Ruzsa et al, 21 in which they demonstrated a 1-year limb salvage rate of 82% using retrograde transpedal access. El-Sayed et al 13 also published results on this variable and they demonstrated a 1-year limb salvage rate of 88% with the use of retrograde pedal access.…”

“…Since this initial study, there has been limited published studies on the outcomes of the SAFARI technique. [5][6][7][8][9] Given this relative paucity of studies, we retrospectively evaluated patients who had undergone the SAFARI procedure at our institution to assess outcomes and factors that my influence them.…”

Endovascular Recanalization of Chronic Total Occlusions of the Native Superficial Femoral Artery After Failed Femoropopliteal Bypass in Patients with Critical Limb Ischemia.

“…Besides, contemporary vascular literature (Baril DT et al, 2010;Laganà D et al, 2011;Dosluoglu HH et al, 2008) on primary endovascular treatment of TASC II C and D femoropopliteal lesions has shown acceptable patency rates compared with those recorded after femoropopliteal bypass, also thanks to the development of endovascular techniques (such as subintimal angioplasty or SAFARI technique) and tools (re-entry devices, stents, etc.) (Hua WR et al, 2013). Hence, such a scienti c background, characterized by the scarcity of alternative endovascular techniques (CDT, mechanical thrombectomy) that are effective and by the presence of still partial but interesting data concerning the patency of TASC II C and D lesions treated with endovascular recanalization as rsttherapy, explains the rationale for considering endovascular recanalization of native SFA CTOs as a treatment hypothesis after femoropopliteal bypass failure, in patients with CLI who refuse surgery or are considered un t for surgery.…”