Transpedal access after failed anterograde recanalization of complex below‐the‐knee and femoropoliteal occlusions in critical limb ischemia

Ruzsa, Zoltán; Nemes, Balázs; Bánsághi, Zoltán; Tóth, Károly; Kuti, Ferenc; Kudrnova, Slavka; Berta, Balázs; Hüttl, Kálmán; Merkely, Béla

doi:10.1002/ccd.25262

Cited by 51 publications

(44 citation statements)

References 27 publications

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“…In a multicenter study Walker et al , reported a high crossing success rate of 85% for infrainguinal CTO via tibiopedal approach. Similar success rates of 78% were also reported by Ruzsa et al . In these studies the TPA was used mainly after a failed antegrade attempt.…”

Section: Discussionsupporting

confidence: 84%

Transradial versus tibiopedal access approach for endovascular intervention of superficial femoral artery chronic total occlusion

Patel

Parikh

Htun

et al. 2018

Cathet Cardio Intervent

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Section: Discussionsupporting

confidence: 84%

Transradial versus tibiopedal access approach for endovascular intervention of superficial femoral artery chronic total occlusion

Patel

Parikh

Htun

et al. 2018

Cathet Cardio Intervent

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“…In the study by Ruzsa et al 51 patients with critical limb ischemia due to occlusion in vessels below the knee were treated by retrograde transpedal recanalization. The success rate of revascularization was 78.4% with one major and three minor complications reported [28]. …”

Section: Discussionmentioning

confidence: 99%

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

Wojtasik-Bakalarz¹,

Arif²,

Chyrchel³

et al. 2017

pwki

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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.

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“…Subintimal angioplasty and stenting is a safe and effective therapy for chronic total occlusion revascularization with favorable patency at mid-term and a longterm patency that is comparable with secondary patency of autologous vein bypass [117][118][119]. In patients with CLI, retrograde pedal access after a failed antegrade recanalization attempt appears to be a safe, feasible and promising technique for limb salvage in high-risk patients who are not surgical candidates [120,121]. There are constantly emerging catheter-based technologies aiming to address these two common problems of CTO recanalization.…”

Section: Chronic Total Occlusionsmentioning

confidence: 98%

Endovascular therapy for critical limb ischemia

Domínguez

Bahadorani

Reeves

et al. 2015

Expert Review of Cardiovascular Therapy

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Critical limb ischemia (CLI) represents an advanced disease state of peripheral arterial disease. It manifests as lower extremity ischemic rest pain or ischemic skin lesions leading to ulceration or gangrene. Patients with CLI often have multiple medical comorbidities and a 1-year mortality rate of 25% and a 1-year amputation rate of 25%. Historically, bypass surgery with autogenous veins for flow restoration has been the first-line therapy for CLI. However, advances in endovascular techniques and device technology have changed the treatment paradigm. Catheter-based technologies are rapidly evolving at a rate that is outpacing large-scale studies evaluating relevant clinical outcomes. Patients with CLI require a multidisciplinary management approach centered on aggressive medical therapies, wound care and prompt revascularization, with an emphasis on limb salvage. This review summarizes the contemporary endovascular therapies including balloon angioplasty, atherectomy and bare-metal stenting. In addition, we review emerging technologies, such as drug-eluting stents, drug-coated balloons and chronic total occlusion recanalization devices.

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Transpedal access after failed anterograde recanalization of complex below‐the‐knee and femoropoliteal occlusions in critical limb ischemia

Cited by 51 publications

References 27 publications

Transradial versus tibiopedal access approach for endovascular intervention of superficial femoral artery chronic total occlusion

Transradial versus tibiopedal access approach for endovascular intervention of superficial femoral artery chronic total occlusion

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

Endovascular therapy for critical limb ischemia

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