Successful thrombolysis of a chronically occluded femoropopliteal synthetic bypass graft via the popliteal approach: case report.

Thrombolysis of an occluded femoropopliteal synthetic bypass graft was performed via the popliteal artery approach for infusion catheter placement and urokinase delivery. Graft thrombolysis was achieved without complication. The proximal graft anastomosis could not be identified and prevented selective antegrade catheter placement and infusion. Because the distal graft anastomosis was visualized, the percutaneous popliteal approach was used. Subsequently, angioplasty was performed of an unmasked stenosis that presumably led to graft closure. We can conclude that selective thrombolysis via catheter placed from popliteal thrombolysis is an effective technique for recanalization of occluded femoropopliteal bypass grafts if the antegrade approach is not feasible.