Transcollateral approach for percutaneous revascularization of complex superficial femoral artery chronic total...

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Endovascular Procedures

Background:

• Chronic total occlusions (CTO) of the superficial femoral artery (SFA) affect a significant portion of patients with symptomatic peripheral arterial disease.
• Antegrade revascularization techniques may fail or be technically unfeasible in complex SFA CTO cases.
• Retrograde approaches, typically via popliteal or tibial vessels, are considered when antegrade methods are unsuccessful.

Observation:

• This report details a novel transcollateral retrograde approach for SFA CTO in two patients.
• Recanalization was achieved via a profunda femoris artery branch, differing from standard retrograde methods.
• The procedure involved retrograde passage of a low-profile balloon, not wire snaring as previously described.

Findings:

• Successful retrograde recanalization of the superficial femoral artery CTO was achieved in both patients.
• The transcollateral retrograde balloon dilation facilitated subsequent antegrade rewiring.
• The endovascular procedures were completed without major complications.

Implications:

• Transcollateral retrograde revascularization represents a valuable alternative strategy for complex SFA CTOs.
• This technique expands the endovascular treatment options for patients with failed antegrade crossing.
• Further investigation into this approach may optimize outcomes for peripheral arterial disease management.