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CardioVascular and Interventional Radiology

, Volume 42, Issue 12, pp 1800–1805 | Cite as

Percutaneous Trans-venous Femoropopliteal Bypass in Long Occlusions of the Superficial Femoral Artery

  • Joseph ToumaEmail author
  • Jean Senemaud
  • Asma Jaziri
  • Frédéric Cochennec
  • Pascal Desgranges
Technical Note Arterial Interventions
  • 183 Downloads
Part of the following topical collections:
  1. Arterial Interventions
  2. Arterial Interventions

Abstract

Purpose

This technical note describes a total percutaneous technique to perform ultrasound and fluoroscopy-assisted femoropopliteal bypass in long superficial femoral artery (SFA) lesions, using standard equipment, through a juxta-anatomical superficial femoral vein (SFV) tunnel.

Materials and methods

Three percutaneous accesses were obtained under ultrasound guidance. The first was retrograde, with crossover maneuver, at the contralateral groin. The second was a proximal SFV-to-SFA stump puncture. The third was a distal popliteal artery-to-popliteal vein puncture. Through the described snaring and capture maneuvers, one single 0.018″ guide wire entered the femoral vein through the SFA stump and re-entered the popliteal artery distally. The fistulous tracts were then dilated and covered stents deployed and post-dilated.

Results

Three patients aged 68 ± 3 years and presenting Rutherford 4 chronic limb ischemia were treated with this technique. The mean SFA lesion length was 22.6 ± 3 cm. The mean procedure duration was 88 ± 18 min. No intraoperative complication occurred. The postoperative course was uneventful. In particular, no deep vein thrombosis occurred. Rutherford stage decreased from 4 to 1 in all patients, with a mean follow-up duration of 6.6 ± 2 months.

Conclusion

The main advantage of the technique is avoiding calcification issues by abandoning the trans-arterial recanalization approach for long calcified lesions. The second interest is its feasibility by simple endovascular means without any particular or dedicated device. However, longer follow-up is needed to assess safety and durability.

Notes

Supplementary material

Supplementary file1 (MP4 71346 kb)

Supplementary file2 (MP4 22838 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  1. 1.Vascular Surgery Department, Paris Est Créteil Faculty of MedicineHenri Mondor University HospitalCréteilFrance
  2. 2.Angiology UnitHenri Mondor University HospitalCréteilFrance

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