Document Detail


Retrograde approach for complex popliteal and tibioperoneal occlusions.
MedLine Citation:
PMID:  18840044     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To describe the technical aspects of the retrograde approach for endovascular treatment of complex popliteal and/or tibioperoneal occlusions and determine its efficacy in minimizing failure rates. METHODS: An observational registry of retrograde revascularizations was maintained at our institution over 14 months (September 2006 to December 2007). During this time frame, antegrade revascularization failed in 62 (17.8%) of 343 limbs with complex total occlusions of the popliteal and/or infrapopliteal vascular territory. Of these antegrade failures, 51 (82.2%) limbs in 51 patients (32 men; mean age 72+/-8 years) were suitable for a retrograde attempt. From this subgroup, 45 (88.2%) were treated via a percutaneous transpedal access site and 6 (11.8%) via a transcollateral intra-arterial technique. RESULTS: The overall success rate was 86.3% (44/51); adjunctive stenting was needed in 21 (41.1%) to optimize results. Only 1 (1.9%) major complication (a pedal access site occlusion) and 4 (7.8%) minor sequelae (arterial perforation in 3 and a pedal hematoma without consequence) were documented. CONCLUSION: In complex popliteal to infrapopliteal occlusions, an antegrade recanalization attempt can fail in up to 20% of the cases. The additional use of a retrograde approach seems feasible and safe and can favorably modify this failure rate. This technique could be valuable for patients with critical limb ischemia due to popliteal and infrapopliteal occlusions once larger studies with follow-up confirm safety, efficacy, and clinical benefit.
Authors:
Miguel Montero-Baker; Andrej Schmidt; Sven Bräunlich; Matthias Ulrich; Marcus Thieme; Giancarlo Biamino; Spiridon Botsios; Yvonne Bausback; Dierk Scheinert
Related Documents :
1122064 - Immediate assessment of vascular operations using segmental plethysmography.
11130104 - Acoustic impedance of an artificially lengthened and constricted vocal tract.
19579204 - The rotarex(r) and aspirex(r) mechanical thrombectomy devices.
20198824 - Evaluation of the pattern of proximal and distal occlusion and collateral circulation o...
2775634 - The in situ bypass above the knee.
8824134 - Carotid stenosis. a neurologist's perspective.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  15     ISSN:  1545-1550     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-08     Completed Date:  2009-08-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  594-604     Citation Subset:  IM    
Affiliation:
Department of Medicine I, Angiology/Cardiology, Park Hospital, University of Leipzig Heart Center, Leipzig, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Arterial Occlusive Diseases / surgery*
Female
Humans
Male
Popliteal Artery*
Tibial Arteries*
Vascular Surgical Procedures / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  TEVAR in Patients With Late Complications of Aortic Coarctation Repair.
Next Document:  Dethrombosis of the Lower Extremity Arteries Using the Power-Pulse Spray Technique in Patients with ...