Percutaneous Reconstruction Techniques: Popliteal Artery Approach for Chronic Total Occlusion of Superficial Femoral and Iliac Arteries

Özet

Objectives: Femoropopliteal artery disease (FPAD) is the most common form of peripheral artery disease. Popliteal artery (PA) puncture enables the use of low-profile sheaths and devices and may be an alternative to the antegrade ipsilateral approach in its treatment. We mainly aimed to discuss the PA retrograde approach with the endovascular treatment (EVT) strategy in FPAD. Materials and Methods: Twenty patients who underwent EVT with retrograde popliteal approach in superficial femoral artery or PA disease were included in this retrospective study. The decision for retrograde approach was made according to the results of computerized tomography or magnetic resonance angiography. All patients underwent color Doppler ultrasonography at the first and sixth months after intervention. The frequency of procedural complications (hematoma, bleeding, and distal embolism) was recorded. Results: Technical success was achieved in all patients. No transfusions or additional surgical treatments were required in any case. Acute success rate was determined as 100% blood flow rate assessed by angiography. The patency rates in treated arteries were recorded by ultrasonographic evaluation in the first and sixth months of the post-operative period. Conclusion: Preoperative evaluation and planning are crucial for the success of interventions in peripheral artery disease. An alternative plan and access site should always be available to ensure success in complex procedures. In light of our findings, retrograde PA puncture can be used safely and effectively in the recanalization of superficial femoral artery and PA stenosis.