J Cardiovasc Interv.  2024 Oct;3(4):221-226. 10.54912/jci.2024.0012.

Use of Retrograde Outback Catheter Through the Pedal Route in a Stumpless Long Superficial Femoral Artery Occlusion

• Kim TH
• Kim JB
• Jang HJ

• KMID: 2561221
• DOI: http://doi.org/10.54912/jci.2024.0012

Abstract

We present a case of successful recanalization of chronic superficial femoral artery (SFA) occlusion using a bidirectional approach. The procedure was ultimately successful with the use of an Outback re-entry catheter inserted through the pedal route. A patient who had previously undergone endovascular aneurysm repair presented with claudication symptoms due to right SFA occlusion. A crossover approach was not feasible because of the bifurcated grafts; although an attempt was made to perform the procedure via an antegrade puncture at the roof of the common femoral artery, crossing the occluded lesion was not possible. After puncturing the distal posterior tibial artery (PTA) near the malleolus, we attempted a bidirectional approach combined with the reverse controlled antegrade and retrograde subintimal tracking techniques; however, this was unsuccessful. Ultimately, we achieved recanalization using a retrograde Outback re-entry catheter in a sheathless manner through the distal PTA. The treated vessel and access site remained intact for up to 2 years postprocedure, and we report the outcomes here.

Keyword

Peripheral artery disease; Abdominal aortic aneurysm; Angioplasty; Balloon