Transpedal SFA revascularization using outback re-entry
-
Upload
ulrich-luft -
Category
Health & Medicine
-
view
94 -
download
5
Transcript of Transpedal SFA revascularization using outback re-entry
![Page 1: Transpedal SFA revascularization using outback re-entry](https://reader034.fdocuments.us/reader034/viewer/2022052705/58a4307a1a28ab3e3d8b5e75/html5/thumbnails/1.jpg)
SFA CTO WITH SAFARI TECHNIQUE
UTILIZING OUTBACK REENTRY
Luft MDEvans DO
![Page 2: Transpedal SFA revascularization using outback re-entry](https://reader034.fdocuments.us/reader034/viewer/2022052705/58a4307a1a28ab3e3d8b5e75/html5/thumbnails/2.jpg)
Vascular Surgery failed in an attempt to recanalize the left SFA in a patient with limiting claudication. Occlusion extends from ostium to distal SFA.
Previous attempts included antegrade subintimal angioplasty with front-runner device and attempts to re-enter with the outback device.
![Page 3: Transpedal SFA revascularization using outback re-entry](https://reader034.fdocuments.us/reader034/viewer/2022052705/58a4307a1a28ab3e3d8b5e75/html5/thumbnails/3.jpg)
Given the previous attempts, we gained pedal access using palpation (I’ve got sensitive fingers) and a Cook micropuncture kit.
Wire was easily advance up to the occlusion
![Page 4: Transpedal SFA revascularization using outback re-entry](https://reader034.fdocuments.us/reader034/viewer/2022052705/58a4307a1a28ab3e3d8b5e75/html5/thumbnails/4.jpg)
Both antegrade and retrograde wire were advanced. Both were subintimal.
We attempted re-entry at both the proximal and distal caps without success.
![Page 5: Transpedal SFA revascularization using outback re-entry](https://reader034.fdocuments.us/reader034/viewer/2022052705/58a4307a1a28ab3e3d8b5e75/html5/thumbnails/5.jpg)
We therefore brought a 4.0mm balloon up from the foot and an outback down from the femoral and punctured the balloon with the re-entry needle. We then brought the wire into the balloon and pulled the balloon and wire through the occlusion. We brought a balloon over the antegrade wire to confirm position.
![Page 6: Transpedal SFA revascularization using outback re-entry](https://reader034.fdocuments.us/reader034/viewer/2022052705/58a4307a1a28ab3e3d8b5e75/html5/thumbnails/6.jpg)
We used a 4.0 and 6.0 balloon to predilate. We stented with iDev Supera stents.
![Page 7: Transpedal SFA revascularization using outback re-entry](https://reader034.fdocuments.us/reader034/viewer/2022052705/58a4307a1a28ab3e3d8b5e75/html5/thumbnails/7.jpg)
FINAL RESULT IN THE SFA
![Page 8: Transpedal SFA revascularization using outback re-entry](https://reader034.fdocuments.us/reader034/viewer/2022052705/58a4307a1a28ab3e3d8b5e75/html5/thumbnails/8.jpg)
FINAL RUNOFF