L Kamper1, P Haage2. 1. Zentrum für Radiologie, HELIOS Klinikum Wuppertal, Klinikum der Universität Witten/Herdecke, Heusnerstr. 40, 42283, Wuppertal, Deutschland. lars.kamper@helios-kliniken.de. 2. Zentrum für Radiologie, HELIOS Klinikum Wuppertal, Klinikum der Universität Witten/Herdecke, Heusnerstr. 40, 42283, Wuppertal, Deutschland.
Abstract
BACKGROUND: Percutaneous interventions in patients with peripheral arterial occlusive disease (PAOD) are usually performed from an antegrade or retrograde transfemoral arterial access; however, sometimes chronic femoropopliteal and crural occlusions cannot be negotiated via this route with traditional standard methods. OBJECTIVES: Description and evaluation of transfemoral, transpopliteal and transpedal vascular approaches for the treatment of advanced PAOD. MATERIAL AND METHODS: A literature review of available studies on endovascular interventions with distal retrograde access was carried out. RESULTS: Most complex arterial occlusions can be treated by employing modern subintimal procedures and/or additional retrograde approaches. The success rate also depends on the expertise with the appropriate technique and materials used. CONCLUSION: The transfemoral access remains the first choice for the treatment of patients with PAOD. Additional retrograde approaches from a more distal access constitute an alternative after failure of antegrade intervention attempts.
BACKGROUND: Percutaneous interventions in patients with peripheral arterial occlusive disease (PAOD) are usually performed from an antegrade or retrograde transfemoral arterial access; however, sometimes chronic femoropopliteal and crural occlusions cannot be negotiated via this route with traditional standard methods. OBJECTIVES: Description and evaluation of transfemoral, transpopliteal and transpedal vascular approaches for the treatment of advanced PAOD. MATERIAL AND METHODS: A literature review of available studies on endovascular interventions with distal retrograde access was carried out. RESULTS: Most complex arterial occlusions can be treated by employing modern subintimal procedures and/or additional retrograde approaches. The success rate also depends on the expertise with the appropriate technique and materials used. CONCLUSION: The transfemoral access remains the first choice for the treatment of patients with PAOD. Additional retrograde approaches from a more distal access constitute an alternative after failure of antegrade intervention attempts.
Authors: Marlon Spreen; Ted Vink; Bob Knippenberg; Jim Reekers; Lukas van Dijk; Jan Wever; Randolph van Eps; Hans van Overhagen Journal: Cardiovasc Intervent Radiol Date: 2014-04-11 Impact factor: 2.740
Authors: R Kevin Rogers; Philip B Dattilo; Joel A Garcia; Thomas Tsai; Ivan P Casserly Journal: Catheter Cardiovasc Interv Date: 2011-03-08 Impact factor: 2.692