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Updated: Feb 23, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Reverse Retrograde Approach: An Alternative Method for Ipsilateral Access to the Superficial Femoral Artery
M Miralles1, E Candela1, E Blanes1
1Hospital Universitari I Politècnic La Fe, Department of Vascular Surgery, Bulevar Sur s/n, 46026 Valencia, Spain.
Abstract:
Access for endovascular treatment of the superficial femoral artery (SFA) is usually gained through an antegrade approach from the ipsilateral common femoral artery (CFA), or by crossing over from the contralateral CFA. In this technical note, an alternative method, based on retrograde access of the ipsilateral iliac artery (IA), and conversion into an antegrade approach to the SFA, is described. Successful reverse ipsilateral catheterisation was obtained in 15/16 patients. Calcification of the CFA and IA required a crossover approach in one case. There were no complications related to the technique, except for moderate bleeding in relation to the deployment of a closure device.
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