Early results of retrograde transpopliteal angioplasty of iliofemoral lesions

To assess whether the retrograde transpopliteal approach is a safe, practical and effective alternative to femoral puncture for percutaneous transluminal angioplasty (PTA). Forty PTAs in 38 patients were evaluated. Intentional subintimal recanalization was performed in 13 limbs. Ultrasound evaluatio...

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Veröffentlicht in:Cardiovascular and interventional radiology 2001-11, Vol.24 (6), p.378-382
Hauptverfasser: SAHA, Saumitra, GIBSON, Matthew, MAGEE, Timothy R, GALLAND, Robert B, TORRIE, E. Peter H
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container_end_page 382
container_issue 6
container_start_page 378
container_title Cardiovascular and interventional radiology
container_volume 24
creator SAHA, Saumitra
GIBSON, Matthew
MAGEE, Timothy R
GALLAND, Robert B
TORRIE, E. Peter H
description To assess whether the retrograde transpopliteal approach is a safe, practical and effective alternative to femoral puncture for percutaneous transluminal angioplasty (PTA). Forty PTAs in 38 patients were evaluated. Intentional subintimal recanalization was performed in 13 limbs. Ultrasound evaluation of the popliteal fossa was carried out 30 min and 24 hr postprocedurally in the first 10 patients to exclude local complications. All patients had a follow-up of at least 6 weeks. The indication for PTA was critical ischemia in seven limbs and disabling claudication in the remainder. Stenoses (single or multiple) were present in 24 and occlusion in 15. The superficial femoral artery (SFA) was the commonest segment affected (36) followed by common femoral artery (CFA) in four and iliac artery in four. Technical success was achieved in 38 of 39 limbs where angioplasty was carried out. In one limb no lesion was found. Immediate complications were distal embolization in two and thrombosis in one. None of these required immediate surgery. There were no puncture site hematomas or popliteal arteriovenous fistulae. Symptomatic patency at 6 weeks was 85%. Further reconstructive surgery was required in three limbs and amputation in two. The transpopliteal approach has a high technical success rate and a low complication rate with a potential to develop into an outpatient procedure. It should be considered for flush SFA occlusions or iliac disease with tandem CFA/SFA disease where the contralateral femoral approach is often technically difficult.
doi_str_mv 10.1007/s00270-001-0043-5
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Peter H</creatorcontrib><title>Early results of retrograde transpopliteal angioplasty of iliofemoral lesions</title><title>Cardiovascular and interventional radiology</title><addtitle>Cardiovasc Intervent Radiol</addtitle><description>To assess whether the retrograde transpopliteal approach is a safe, practical and effective alternative to femoral puncture for percutaneous transluminal angioplasty (PTA). Forty PTAs in 38 patients were evaluated. Intentional subintimal recanalization was performed in 13 limbs. Ultrasound evaluation of the popliteal fossa was carried out 30 min and 24 hr postprocedurally in the first 10 patients to exclude local complications. All patients had a follow-up of at least 6 weeks. The indication for PTA was critical ischemia in seven limbs and disabling claudication in the remainder. Stenoses (single or multiple) were present in 24 and occlusion in 15. 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Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Reoperation</topic><topic>SURGERY</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>VASCULAR DISEASES</topic><topic>Vascular Patency - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SAHA, Saumitra</creatorcontrib><creatorcontrib>GIBSON, Matthew</creatorcontrib><creatorcontrib>MAGEE, Timothy R</creatorcontrib><creatorcontrib>GALLAND, Robert B</creatorcontrib><creatorcontrib>TORRIE, E. 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Peter H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early results of retrograde transpopliteal angioplasty of iliofemoral lesions</atitle><jtitle>Cardiovascular and interventional radiology</jtitle><addtitle>Cardiovasc Intervent Radiol</addtitle><date>2001-11-01</date><risdate>2001</risdate><volume>24</volume><issue>6</issue><spage>378</spage><epage>382</epage><pages>378-382</pages><issn>0174-1551</issn><eissn>1432-086X</eissn><coden>CAIRDG</coden><abstract>To assess whether the retrograde transpopliteal approach is a safe, practical and effective alternative to femoral puncture for percutaneous transluminal angioplasty (PTA). Forty PTAs in 38 patients were evaluated. Intentional subintimal recanalization was performed in 13 limbs. Ultrasound evaluation of the popliteal fossa was carried out 30 min and 24 hr postprocedurally in the first 10 patients to exclude local complications. All patients had a follow-up of at least 6 weeks. The indication for PTA was critical ischemia in seven limbs and disabling claudication in the remainder. Stenoses (single or multiple) were present in 24 and occlusion in 15. The superficial femoral artery (SFA) was the commonest segment affected (36) followed by common femoral artery (CFA) in four and iliac artery in four. Technical success was achieved in 38 of 39 limbs where angioplasty was carried out. In one limb no lesion was found. Immediate complications were distal embolization in two and thrombosis in one. None of these required immediate surgery. There were no puncture site hematomas or popliteal arteriovenous fistulae. Symptomatic patency at 6 weeks was 85%. Further reconstructive surgery was required in three limbs and amputation in two. The transpopliteal approach has a high technical success rate and a low complication rate with a potential to develop into an outpatient procedure. It should be considered for flush SFA occlusions or iliac disease with tandem CFA/SFA disease where the contralateral femoral approach is often technically difficult.</abstract><cop>Heidelberg</cop><cop>Berlin</cop><pub>Springer</pub><pmid>11907743</pmid><doi>10.1007/s00270-001-0043-5</doi><tpages>5</tpages></addata></record>
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subjects Aged
Angioplasty, Balloon
Anticoagulants - therapeutic use
Arterial Occlusive Diseases - complications
Arterial Occlusive Diseases - mortality
Arterial Occlusive Diseases - therapy
ARTERIES
Biological and medical sciences
Combined Modality Therapy
Diseases of the cardiovascular system
Embolization, Therapeutic
EVALUATION
Female
Femoral Artery - pathology
Femoral Artery - surgery
FISTULAE
Follow-Up Studies
HEMATOMAS
Heparin - therapeutic use
Humans
Iliac Artery - pathology
Iliac Artery - surgery
Intermittent Claudication - etiology
Intermittent Claudication - therapy
Ischemia - complications
Ischemia - mortality
Ischemia - therapy
Leg - blood supply
Leg - surgery
LIMBS
Male
Medical sciences
Middle Aged
PATIENTS
Popliteal Artery - pathology
Popliteal Artery - surgery
RADIOLOGY AND NUCLEAR MEDICINE
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Reoperation
SURGERY
Time Factors
Treatment Outcome
VASCULAR DISEASES
Vascular Patency - physiology
title Early results of retrograde transpopliteal angioplasty of iliofemoral lesions
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