Ibrahim Georges, Nabhani Sami, Feghaly Michel
Division of Vascular Surgery, Saint Georges Hospital-University Medical Center, Ashrafieh, Beirut, Lebanon.
Int J Vasc Med. 2021 May 17;2021:8833025. doi: 10.1155/2021/8833025. eCollection 2021.
Retrograde popliteal access has long been established as an alternative to the antegrade approach to occlusive lesions in the superficial femoral artery (SFA). However, early reports with high complication rates (dissection, hematomas, aneurysms, and arteriovenous shunts at the puncture site) reduced enthusiasm for this technique. In recent years, with the development of thinner sheaths and low profile angioplasty devices, retrograde popliteal access has resurfaced as a viable technique, mostly in combination with or after failure of the more classical antegrade approach. In this retrospective study, we will report the safety and efficacy of the retrograde popliteal approach in the treatment of superficial femoral artery chronic total occlusions, in 13 consecutive patients between January 2017 and January 2021. The results showed 100% successful puncture of the popliteal artery and 100% successful recanalization and stenting of the superficial femoral artery with a total of 2 complications related to the puncture site and zero periprocedural mortality. In conclusion, the retrograde popliteal approach appears to be an effective and safe alternative to the common SFA complete total occlusion (CTO) treatment approach.
长期以来，逆行腘动脉入路一直被确立为股浅动脉（SFA）闭塞性病变顺行入路的替代方法。然而，早期报告显示该技术并发症发生率较高（穿刺部位出现夹层、血肿、动脉瘤和动静脉分流），这降低了人们对该技术的热情。近年来，随着更细鞘管和低轮廓血管成形术器械的发展，逆行腘动脉入路作为一种可行的技术重新出现，主要是在更经典的顺行入路失败后或与之联合使用。在这项回顾性研究中，我们将报告2017年1月至2021年1月期间连续13例患者采用逆行腘动脉入路治疗股浅动脉慢性完全闭塞的安全性和有效性。结果显示腘动脉穿刺成功率为100%，股浅动脉再通和支架置入成功率为100%，共有2例与穿刺部位相关的并发症，围手术期死亡率为零。总之，逆行腘动脉入路似乎是股浅动脉完全闭塞（CTO）常见治疗方法的一种有效且安全的替代方案。
