| Retrograde approach for complex popliteal and tibioperoneal occlusions. | |
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MedLine Citation:
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PMID: 18840044 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Miguel Montero-Baker; Andrej Schmidt; Sven Bräunlich; Matthias Ulrich; Marcus Thieme; Giancarlo Biamino; Spiridon Botsios; Yvonne Bausback; Dierk Scheinert |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 2008-10-08 Completed Date: 2009-08-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100896915 Medline TA: J Endovasc Ther Country: United States |
Other Details:
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Languages: eng Pagination: 594-604 Citation Subset: IM |
Affiliation:
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Department of Medicine I, Angiology/Cardiology, Park Hospital, University of Leipzig Heart Center, Leipzig, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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
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