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A breakthrough trans-collateral retrograde access for occlusive superficial femoral artery: multi-site access and sheaths insertion (MUSASHI) technique

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Abstract

A purpose of this article is to describe a breakthrough technique for occlusive superficial femoral artery (SFA) recanalization: multi-site access and sheaths insertion (MUSASHI) technique. Trans-collateral retrograde approach (TCA) for SFA cannot become popular because it needs conventional (crossover or ipsilateral) approach, which might not be suitable for collateral channel tracking. An innovative MUSASHI technique has a possibility to make TCA popular. Inserting two different sheaths into SFA and profunda artery from common femoral artery, we can manipulate both antegrade and retrograde guidewires without losing their trackability and with strong system-stability. Using MUSASHI technique, TCA may become easier and safer.

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References

  1. Norgen L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007;45(Suppl):S5–67.

    Article  Google Scholar 

  2. European Stroke Organisation, Tendera M, Aboyans V, Bartelink ML, Baumgartner I, Clément D, et al. ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries: the task force on the diagnosis and treatment of peripheral artery diseases of the European Society of Cardiology (ESC). Eur Heart J. 2011;32(22):2851–906.

    Article  Google Scholar 

  3. Bown MJ, Bolia A, Sutton AJ. Subintimal angioplasty: meta-analytical evidence of clinical utility. Eur J Vasc Endovasc Surg. 2009;38:323–37.

    Article  CAS  PubMed  Google Scholar 

  4. Cutress ML, Blanshard K, Shaw M, Bown M, White S, Sayers RD. Retrograde subintimal angioplasty via a popliteal artery approach. Eur J Vasc Endovasc Surg. 2002;23:275–6.

    Article  CAS  PubMed  Google Scholar 

  5. Tokuda T, Hirano K, Muramatsu T, Tsukahara R, Nakano M. A sheathless retrograde approach via the popliteal artery is useful and safe for treating chronic total occlusions in the superficial femoral artery. J Endovasc Ther. 2014;15:289–95.

    Article  Google Scholar 

  6. Fusaro M. Dalla Paola L, Biondi-Zoccai GG. Retrograde posterior tibial artery access for below-the-knee percutaneous revascularization by means of sheathless approach and double wire technique. Minerva Cardioangiol. 2006;54(6):773–7.

    CAS  PubMed  Google Scholar 

  7. Hua WR, Yi MQ, Min TL, Feng SN, Xuan LZ, Xing J. Popliteal versus tibial retrograde access for subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) technique. Eur J Vasc Endovasc Surg. 2013;46(2):249–54.

    Article  CAS  PubMed  Google Scholar 

  8. Hosam F. Retrograde pedal/tibial artery access for treatment of infragenicular arterial occlusive disease. Methodist Debakey Cardiovasc J. 2013;9(2):73–8.

    Article  Google Scholar 

  9. Iida T, Iida O, Okamoto S, Dohi T, Nanto K, Uematsu M. Endovascular therapy with novel high anterior tibial artery puncture for limb salvage in a case of critical lower limb ischemia. Cardiovasc Interv Ther. 2014; published online 14 January 2014.

  10. Zhuang KD, Tan SG, Tay KH. The “SAFARI” technique using retrograde access via peroneal artery access. Cardiovasc Intervent Radiol. 2012;35(4):927–31.

    Article  PubMed  Google Scholar 

  11. Urasawa K, Sato K, Koshida R, Honma Y. Trans-collateral angioplasty for the treatment of long chronic total occlusions of superficial femoral arteries: novel wiring technique. J Cardiovasc Surg (Toriono). 2011;52:1–2.

    Google Scholar 

  12. Shimada Y, Kino N, Yano K, Tonomura D, Takehara K, Furuhayashi K, Kurotobi T, Tsuchida T, Fukumoto H. Transcollateral retrograde approach with rendezvous technique for recanalization of chronically occluded tibial arteries. J Endovasc Ther. 2012;19:620–6.

    Article  PubMed  Google Scholar 

  13. Yanagita Y, Noda K. Incidence and risk factors of vascular complications following endovascular treatment of peripheral arterial disease via the popliteal artery. Cardiovasc Interv Ther. 2011;26:209–14.

    Article  PubMed  Google Scholar 

  14. Saim Y, Timur S, Abdullah E, Atalay M, Ersin L. Hematoma after percutaneous transpopliteal stenting and remote suturing of the popliteal artery. J Endovasc Ther. 2002;9:703–6.

    Article  Google Scholar 

  15. Surmely JF, Tsuchikane E, Katoh O, Nishida Y, Nakayama M, Nakamura S, Oida A, Hattori E, Suzuki T. New concept for CTO recanalization using controlled antegrade and retrograde subintimal tracking: the CART technique. J Incas Cardiol. 2006;18:334–8.

    Google Scholar 

  16. Andrej S, Yvonne B, Michael P, Martin W, Sven B, Matthias U, Romon V, Josef F, Johannes S, Spiridon B, Direk S. Retrograde recanalization technique for chronic femoral artery occlusions. J Endovasc Ther. 2012;19:23–9.

    Article  Google Scholar 

  17. George LA, Steve JG, Jon G, Jihad AM. Exotic access, techniques, and devices for infrapopliteal CTOs, recommendations on how to successfully cross chronic total occlusions of the infrapopliteal vasculature. Endovasc Today. 2012;5:44–9.

    Google Scholar 

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Correspondence to Tatsuya Nakama.

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Nakama, T., Shibata, Y., Kimura, T. et al. A breakthrough trans-collateral retrograde access for occlusive superficial femoral artery: multi-site access and sheaths insertion (MUSASHI) technique. Cardiovasc Interv and Ther 30, 356–361 (2015). https://doi.org/10.1007/s12928-014-0304-2

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