Home > Journals > The Journal of Cardiovascular Surgery > Past Issues > The Journal of Cardiovascular Surgery 2014 August;55(4) > The Journal of Cardiovascular Surgery 2014 August;55(4):465-71

CURRENT ISSUE
 

ARTICLE TOOLS

Reprints

THE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632


eTOC

 

REVIEWS  LATEST DEVELOPMENTS IN SFA MANAGEMENT


The Journal of Cardiovascular Surgery 2014 August;55(4):465-71

language: English

Retrograde recanalization of complex SFA lesions. Indications and techniques

Fanelli F., Cannavale A.

Vascular and Interventional Radiology Unit, Department of Radiological Sciences, “Sapienza” University, Rome, Italy


PDF  


Femoro-popliteal segment is often characterized by diffuse and severe steno-obstructive atheroclerotic disease. Most recent guidelines recommended endovascular techniques as a valid and safe treatment in highly symptomatic patients (Rutherford class 4 to 6) with complex femoropopliteal lesions (TASC C and D). Continuous technical development is increasing the efficacy of the endovascular technique with the introduction of new dedicated devices. In most complex situation also retrograde recanalization can be applied. The main indication to this technique is when conventional antegrade recanalisation fails or cannot be apply. The most common retrograde access is through the popliteal artery. However many operators do not like this approach due to the technical issue correlated to the patient position. Recently several reports have been published keeping the patient supine improving patient comfort and operator activity. This tehnique was also affected by several complications at the level of the popliteal puncture site, but those were resolved with the improvement of technique and operator skills. Hence several Authors described different variants of such technique (subintimal techniques, patient in supine position, puncture of the distal superficial femoral artery, tibial/pedal artery access) all obtaining an high rate of success with a low complication rate. In conclusion retrograde recanalization can be considered a safe and effective technique for complex femoral lesions. It is also less expensive than recanalisation devices, less time consuming and can increase the outcome due to the higher percentage of intraluminal recanalization.

top of page

Publication History

Cite this article as

Corresponding author e-mail

fabrizio.fanelli@uniroma1.it