The purpose of this study was to describe the efficacy of planned combined subintimal arterial flossing with antegrade– retrograde intervention (SAFARI) to obtain the precise recanalization of the patent portion of a distal runoff vessel in critical limb ischemia (CLI) patients presenting long occlusions involving the popliteal trifurcation. Four patients at risk of limb loss due to long occlusions involving the leg vessel tree and not suitable for a surgical bypass were treated by the subintimal antegrade and retrograde (posterior tibial or anterior tibial artery) approach. The patent portion of the runoff vessel was previously assessed by magnetic resonance angiography (MRA) and directly punctured under Doppler ultrasound (US) guidance. A subintimal channel rendezvous was performed to allow snaring of the guidewires. Subsequently, a balloon dilatation was performed without stent deployment. All patients were successfully recanalized and had complete healing of the limb lesions. At the 12-month follow-up all patients showed clinical improvement with no major complications related to the procedure. This combined antegrade and retrograde subintimal approach is currently an excellent endovascular option in patients with long occlusions extending onto the leg vessels trifurcation and at risk of limb loss. Key words: Critical limb ischemia—Subintimal technique— Popliteal branches—Retrograde access

Gandini, R., Pipitone, V., Stefanini, M., Maresca, L., Spinelli, A., Colangelo, V., et al. (2007). The "Safari" technique to perform difficult subintimal infragenicular vessels. CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, 30, 469-473 [10.1007/s00270-006-0099-3].

The "Safari" technique to perform difficult subintimal infragenicular vessels

GANDINI, ROBERTO;PAMPANA, ENRICO;SIMONETTI, GIOVANNI MARIA EGISTO
2007-01-01

Abstract

The purpose of this study was to describe the efficacy of planned combined subintimal arterial flossing with antegrade– retrograde intervention (SAFARI) to obtain the precise recanalization of the patent portion of a distal runoff vessel in critical limb ischemia (CLI) patients presenting long occlusions involving the popliteal trifurcation. Four patients at risk of limb loss due to long occlusions involving the leg vessel tree and not suitable for a surgical bypass were treated by the subintimal antegrade and retrograde (posterior tibial or anterior tibial artery) approach. The patent portion of the runoff vessel was previously assessed by magnetic resonance angiography (MRA) and directly punctured under Doppler ultrasound (US) guidance. A subintimal channel rendezvous was performed to allow snaring of the guidewires. Subsequently, a balloon dilatation was performed without stent deployment. All patients were successfully recanalized and had complete healing of the limb lesions. At the 12-month follow-up all patients showed clinical improvement with no major complications related to the procedure. This combined antegrade and retrograde subintimal approach is currently an excellent endovascular option in patients with long occlusions extending onto the leg vessels trifurcation and at risk of limb loss. Key words: Critical limb ischemia—Subintimal technique— Popliteal branches—Retrograde access
2007
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/30 - MALATTIE APPARATO VISIVO
Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA
English
Con Impact Factor ISI
Critical limb ischemia—Subintimal technique— Popliteal branches—Retrograde access
Gandini, R., Pipitone, V., Stefanini, M., Maresca, L., Spinelli, A., Colangelo, V., et al. (2007). The "Safari" technique to perform difficult subintimal infragenicular vessels. CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, 30, 469-473 [10.1007/s00270-006-0099-3].
Gandini, R; Pipitone, V; Stefanini, M; Maresca, L; Spinelli, A; Colangelo, V; Reale, C; Pampana, E; Simonetti, Gme
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/14506
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