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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
REVIEWS LIMB SALVAGE
Italian Journal of Vascular and Endovascular Surgery 2010 Marzo;17(1):15-21
Tips, tricks and bail out strategies for subintimal angioplasty
Meier G. H.
Department of Vascular Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
The treatment of lower extremity arterial occlusion using subintimal angioplasty is a challenging, yet often successful solution in treating high-risk patients. While these techniques have been used for many years, there remain many technical tricks which may facilitate performance of these procedures. The challenges result from limitations in wire and catheter passage, particularly in calcified sections of the superficial femoral artery. Access, entry, traversal of the subintimal space, and re-entry into the true lumen all have technical issues that improve with experience. In spite of the challenges, subintimal angioplasty can be a very successful treatment in many patients with lower extremity arterial occlusive disease.