Yıl 2025,
Cilt: 35 Sayı: 1, 167 - 173, 28.02.2025
Mehmet Cingöz
,
Çağrı Erdim
,
Mustafa Fatih Arslan
,
Ali Dablan
,
Oğuzhan Türksayar
,
Tevfik Güzelbey
Kaynakça
- 1. Varu VN, Hogg ME, Kibbe MR. Critical limb ischemia. J. Vasc. Surg. 2010;51:230-41.
- 2. Wiesinger B, Heller S, Schmehl J, et al. Percutaneous vascular interventions in the superficial femoral artery. A review. Minerva Cardioangiol. 2006;54:83-93.
- 3. Wheatley BJ, Mansour MA, Grossman PM, et al. Complication rates for percutaneous lower extremity arterial antegrade access. Arch. Surg. 2011;146:432-5.
- 4. Barbetta I, van den Berg JC, editors. Access and hemostasis: femoral and popliteal approaches and closure devices—why, what, when, and how? Semin Intervent Radiol.; 2014: Thieme Medical Publishers.
- 5. Sethi A, Arora RR. Medical management and cardiovascular risk reduction in peripheral arterial disease. Exp Clin Cardiol. 2008;13:113.
- 6. Tønnesen KH, Sager P, Karle A, Henriksen L, Jørgensen B. Percutaneous transluminal angioplasty of the superficial femoral artery by retrograde catheterization via the popliteal artery. Cardiovasc. Interv. Radiol. 1988;11:127-31.
- 7. Ye M, Zhang H, Huang X, et al. Retrograde popliteal approach for challenging occlusions of the femoral-popliteal arteries. J. Vasc. Surg. 2013;58:84-9.
- 8. Ueshima D, Ashikaga T, Shimura T, et al. The popliteal retrograde approach is effective and safe for superficial femoral artery chronic total occlusion. Ann. Vasc. Dis. 2015;8:220-6.
- 9. Leachman DR, Avedissian MG, Krajcer Z, Angelini P. Transluminal laser angioplasty of the femoropopliteal circulation by use of a percutaneous popliteal approach. Am J Cardiol. 1989;64:106-8.
- 10. Ko Y-G, Kim J-S, Choi D-H, Jang Y, Shim W-H. Improved technical success and midterm patency with subintimal angioplasty compared to intraluminal angioplasty in long femoropopliteal occlusions. J Endovasc Ther. 2007;14:374-81.
- 11. Saab F, Jaff MR, Diaz-Sandoval LJ, et al. Chronic Total Occlusion crossing approach based on Plaque cap morphology: the CTOP classification. J Endovasc Ther. 2018;25:284-91.
- 12. Bazan HA, Le L, Donovan M, et al. Retrograde pedal access for patients with critical limb ischemia. J. Vasc. Surg. 2014;60:375-82.
- 13. Fanelli F, Lucatelli P, Allegritti M, et al. Retrograde popliteal access in the supine patient for recanalization of the superficial femoral artery: initial results. J Endovasc Ther. 2011;18:503-9.
Retrograde Pedal Artery Access versus Conventional Common Femoral Artery Access in Isolated Superficial Femoral Artery Lesions
Yıl 2025,
Cilt: 35 Sayı: 1, 167 - 173, 28.02.2025
Mehmet Cingöz
,
Çağrı Erdim
,
Mustafa Fatih Arslan
,
Ali Dablan
,
Oğuzhan Türksayar
,
Tevfik Güzelbey
Öz
Aim: The current study compared the efficacy and safety of retrograde pedal artery (PA) access versus conventional common femoral artery (CFA) access in managing isolated superficial femoral artery (SFA) occlusions or severe stenoses.
Materials and Methods: A retrospective analysis was conducted on 34 patients treated between June 2020 and November 2023. The patients were categorized into two groups: 12 patients with PA access and 22 with CFA access. Technical success, complication rates, stent usage, procedure duration, and radiation doses were analyzed.
Results: Technical success was achieved in 92.8% of the patients in the PA access group and 84% of the CFA access group (p = 0.636). Complications at the access site were significantly lower in the PA access group, with no hematomas or pseudoaneurysms observed, while both hematomas (32%) and pseudoaneurysms (16%) were noted in the CFA group (p = 0.033). Stent usage was similar between the two groups (21.4% PA vs. 28% CFA, p = 0.721). Median procedure durations were 43 minutes (IQR 27.5–59) for PA and 47 minutes (IQR 29–64) for CFA (p = 0.446). Median total air kerma dose was 280 mGy (IQR 166.5–326.75) for PA and 225 mGy (IQR 145–489) for CFA (p = 0.826).
Conclusions: Retrograde PA access is a viable and safe alternative to CFA access, particularly for patients with complex femoral anatomy, offering similar efficacy with fewer access site complications.
Kaynakça
- 1. Varu VN, Hogg ME, Kibbe MR. Critical limb ischemia. J. Vasc. Surg. 2010;51:230-41.
- 2. Wiesinger B, Heller S, Schmehl J, et al. Percutaneous vascular interventions in the superficial femoral artery. A review. Minerva Cardioangiol. 2006;54:83-93.
- 3. Wheatley BJ, Mansour MA, Grossman PM, et al. Complication rates for percutaneous lower extremity arterial antegrade access. Arch. Surg. 2011;146:432-5.
- 4. Barbetta I, van den Berg JC, editors. Access and hemostasis: femoral and popliteal approaches and closure devices—why, what, when, and how? Semin Intervent Radiol.; 2014: Thieme Medical Publishers.
- 5. Sethi A, Arora RR. Medical management and cardiovascular risk reduction in peripheral arterial disease. Exp Clin Cardiol. 2008;13:113.
- 6. Tønnesen KH, Sager P, Karle A, Henriksen L, Jørgensen B. Percutaneous transluminal angioplasty of the superficial femoral artery by retrograde catheterization via the popliteal artery. Cardiovasc. Interv. Radiol. 1988;11:127-31.
- 7. Ye M, Zhang H, Huang X, et al. Retrograde popliteal approach for challenging occlusions of the femoral-popliteal arteries. J. Vasc. Surg. 2013;58:84-9.
- 8. Ueshima D, Ashikaga T, Shimura T, et al. The popliteal retrograde approach is effective and safe for superficial femoral artery chronic total occlusion. Ann. Vasc. Dis. 2015;8:220-6.
- 9. Leachman DR, Avedissian MG, Krajcer Z, Angelini P. Transluminal laser angioplasty of the femoropopliteal circulation by use of a percutaneous popliteal approach. Am J Cardiol. 1989;64:106-8.
- 10. Ko Y-G, Kim J-S, Choi D-H, Jang Y, Shim W-H. Improved technical success and midterm patency with subintimal angioplasty compared to intraluminal angioplasty in long femoropopliteal occlusions. J Endovasc Ther. 2007;14:374-81.
- 11. Saab F, Jaff MR, Diaz-Sandoval LJ, et al. Chronic Total Occlusion crossing approach based on Plaque cap morphology: the CTOP classification. J Endovasc Ther. 2018;25:284-91.
- 12. Bazan HA, Le L, Donovan M, et al. Retrograde pedal access for patients with critical limb ischemia. J. Vasc. Surg. 2014;60:375-82.
- 13. Fanelli F, Lucatelli P, Allegritti M, et al. Retrograde popliteal access in the supine patient for recanalization of the superficial femoral artery: initial results. J Endovasc Ther. 2011;18:503-9.