E-ISSN 1305-3612
Interventional Radiology - Original Article
Combined percutaneous direct puncture of occluded artery – antegrade intervention to recanalization of below the knee arteries
1 Department of Radiology, İstanbul Başkent University School of Medicine, İstanbul, Turkey  
Diagn Interv Radiol ; : -

Abstract

PURPOSE: The purpose of this study was to assess the technical success of the combined percutaneous direct puncture of occluded artery – antegrade intervention technique and the clinical efficacy of treatment, on the basis of changes in the Rutherford classification.

 

METHODS: Between June 2015 and July 2018, 441 patients underwent endovascular recanalization due to lower limb peripheral arterial disease at our center. Of these, 18 (4%) patients (15 males, 3 females; mean age 63.2) had failed antegrade recanalization and percutaneous retrograde access because of long segment occlusion, arterial rupture or dissection. Combined percutaneous direct puncture of occluded artery - antegrade approach was applied to these patients. Clinical follow-up examinations were applied at 1-month, 3-months and 6- months, and annually thereafter .

 

RESULTS: The mean follow-up period was 22.8±10.9 months. The mean procedure time was 93.6±28.2 min. Technical success was achieved in 14 (78%) patients. Complete restoration of arterial flow in the punctured vessel could not be achieved in 4 (22%) patients. Minor complications occurred in 4 of 18 (22%) procedures. Amputation-free survival and limb salvage rates (83.3% and 100%, respectively) were the same for 12 and 24 months.

 

CONCLUSION: Technical success in lower limb peripheral arterial disease may be improved with the use of a combined percutaneous direct puncture of occluded artery - antegrade intervention, particularly for patients where other techniques are not a viable option.

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