Transpedal approach for iliac artery intervention: A rare case report

Year 2019, , 1430 - 1435, 15.04.2019

Hakan Kaya

https://doi.org/10.30569/adiyamansaglik.488010

Abstract

Achieving
arterial blood flow again is the main priority for the patients having critical
foot ischemia in terms of protecting foot. In recent years, more operations
have been done to save foot with the increase in cardiovascular techniques and
skills. Antegrade attempts in foot artery occlusion result in failure
approximately by %20. Retrograde approaches are usually applied to the
popliteal and infrapopliteal arteries. Very rarely, retrograde approach is
applied in femoral artery occlusions. In this case, a very rare case provided
with successful recanalization through a retrograde approach for a patient
having fully clogged arteries from  right
external iliac artery outlet  to popliteal
artery  is presented.

Keywords

iliac artery disease, transpedal approach

İliak arter girişimi için transpedal yaklaşım: Nadir bir olgu sunumu

Abstract

Arteryel kan akımının yeniden
sağlanması, ayak koruyucu olarak kritik ayak iskemisi olan hastaların başlıca
önceliğidir. Son yıllarda, kardiyovasküler teknik ve becerilerdeki artışla ayak
korumak için daha fazla operasyon yapılmıştır. Ayak arter tıkanıklığında
antegrad girişimler, yaklaşık% 20 oranında başarısızlığa neden olur. Retrograd
yaklaşımlar ise genellikle diz ve diz altı arter tıkanıklıklarında uygulanır.
Çok seyrek olarak femoral arter tıkıanıklıklarında da retrograd yaklaşım
uygulanır. Bu vakada ise sağ external  iliak
arter çıkışından başlayıp popliteal artere kadar uzanan  tamamen  tıkanmış arter segmentine  sahip bir hastada  retrograd yaklaşımla başarılı bir rekanalizasyonun
sağlandığı çok daha nadir bir olgu sunulmaktadır.

Keywords

iliak arter hastalığ, transpedal yaklaşım

References

• 1. Becker GJ, Katzen BT, Dake MD. Noncoronary angioplasty. Radiology 1989; 170:403–412.
• 2. Ingl H, Nasim A, Bolia A, et al. Subintimal angioplasty of isolated infrageniculate vessels in lower limb ischemia: long-term results. J Endovasc Ther 2002; 9:411–416.
• 3. Biancari F, Kantonen I, Alback A, et al. Popliteal-to-distal bypass grafts for critical leg ischemia. J Cardiovasc Surg 2000; 41:281–286.
• 4. Tonnesen KH, Sager P, Karle A ,Henriksen L, Jorgensen B. Percutaneous transluminal angioplasty of the superficial femoral artery by retrograde catheterization via the popliteal artery. Cardiovasc Intervent Radiol 1988; 11:127–131.
• 5. Spinosa DJ, Harthun NL, Bissonette EA, et al. Subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) for subinitimal recanalization to treat chronic critical limb ischemia. J Vasc Intervent Radiol 2005; 16:37–44.
• 6. Wolfe JH, Wyatt MG. Critical and subcritical ischaemia. Eur J Vasc Endovasc Surg 1997; 13:578–582.
• 7. Goshima KR, Mills JL, Sr, Hughes JD. A new look at outcomes after infrainguinal bypass surgery: traditional reporting standards systematically underestimate the expenditure of effort required to attain limb salvage. J Vasc Surg 2004; 39:330–335.
• 8. Faglia E, Dalla Paola L, Clerici G, et al. Peripheral angioplasty as the first-choice revascularization procedure in diabetic patients with critical limb ischemia: prospective study of 993 consecutive patients hospitalized and followed between 1993 and 2003. Eur J Vasc Endovasc Surg 2005; 29:620–627.
• 9. The Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC). European Heart Journal (2011) 32, 2851–2906 doi:10.1093/eurheartj/ehr211
• 10. Sidhu R, Pigott J, Pigott M, et al. Subintimal angioplasty for advanced lower extremity ischemia due to TASC II C and D lesions of the superficial femoral artery. Vasc Endovascular Surg 2010; 44:633–637.
• 11. Fusaro M, Agostoni P, Biondi-Zoccai G. “Trans-collateral” angioplasty for a challenging chronic total occlusion of the tibial vessels: a novel approach to percutaneous revascularization in critical lower limb ischemia. Catheter Cardiovasc Interv 2008; 71:268–272.
• 12. Manzi M, Fusaro M, Ceccacci T, et al. Clinical results of below-the knee intervention using pedal-plantar loop technique for the revascularization of foot arteries. J Cardiovasc Surg (Torino) 2009; 50:331–337.
• 13. Fusaro M, Dalla Paola L, Biondi-Zoccai G. Pedal-plantar loop technique for a challenging below-the-knee chronic total occlusion: a novel approach to percutaneous revascularization in critical lower limb ischemia. J Invasive Cardiol 2007;19:E34–E37.
• 14. Ikushima I, Hirai T, Ishii A, et al. Confluent two-balloon technique: an alternative method for subintimal recanalization of peripheral arterial occlusion. J Vasc Interv Radiol 2011; 22:1139–1143.
• 15. Miguel Montero-Baker et al. Retrograde approach for complex popliteal and tibioperoneal occlusions. J Endovasc Ther 2008; 15:594–604.