Document Detail

The combined ipsilateral antegrade-retrograde approach to insert an endoluminal femoropopliteal bypass.
MedLine Citation:
PMID:  21802237     Owner:  NLM     Status:  MEDLINE    
The endoluminal femoropopliteal bypass is a minimally invasive treatment modality for occlusive superficial femoral artery disease. Technical failure of endovascular treatment of chronic total occlusions is often caused by the inability to re-enter the true lumen. Re-entry devices have a high technical success-rate, but increased procedural costs. We describe an alternative technique using an ipsilateral combined antegrade-retrograde approach to insert an endoluminal femoropopliteal bypass. In a supine position, with the leg elevated at 30 degrees, the popliteal artery is punctured and a 4F introducer sheath is introduced. The occlusion is crossed from distal to proximal and the wire is advanced through a 6F sheath that is positioned in the common femoral artery. The occlusion is predilated from proximal and the "re-entry" site is identified on an angiogram. The wire is then withdrawn into the balloon catheter and advanced intraluminally into one of the crural vessels. After confirming the intraluminal position of the wire, the 4F sheath is removed, and the endoluminal bypass is created in a standardized fashion. The ipsilateral antegrade-retrograde approach is a fast, inexpensive, and easy-to-learn technique, using standard materials only. The distal entry of the occlusion will lead to a minimization of the length of the endoluminal bypass, thereby possibly sparing collaterals and future surgical options.
Mare M A Lensvelt; Clark J Zeebregts; Martine Stoer-Bouwman; Michel M P J Reijnen
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Publication Detail:
Type:  Journal Article     Date:  2011-07-29
Journal Detail:
Title:  Journal of vascular surgery     Volume:  54     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-05     Completed Date:  2011-11-18     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1205-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
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MeSH Terms
Angioplasty, Balloon / instrumentation,  methods*
Arterial Occlusive Diseases / therapy*
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation / instrumentation,  methods*
Chronic Disease
Constriction, Pathologic
Femoral Artery*
Patient Positioning
Popliteal Artery*
Prosthesis Design
Supine Position
Treatment Outcome

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

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