Popliteal Retrograde Approach is Effective and Safe for Superficial Femoral Artery Chronic Total Occlusion

Daisuke Ueshima; Takashi Ashikaga; Tsukasa Shimura; Yu Hatano; Taro Sasaoka; Ken Kurihara; Shunji Yoshikawa; Yasuhiro Maejima; Mitsuaki Isobe

doi:10.3400/avd.oa.15-00025

Original Articles

Popliteal Retrograde Approach is Effective and Safe for Superficial Femoral Artery Chronic Total Occlusion

Daisuke Ueshima, Takashi Ashikaga, Tsukasa Shimura, Yu Hatano, Taro Sasaoka, Ken Kurihara, Shunji Yoshikawa, Yasuhiro Maejima, Mitsuaki Isobe

Author information

Daisuke Ueshima
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
Takashi Ashikaga
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
Tsukasa Shimura
Division of Cardiology, Yokohama City Minato Red Cross Hospital, Tokyo, Japan
Yu Hatano
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
Taro Sasaoka
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
Ken Kurihara
Division of Cardiology, Ome Municipal General Hospital, Tokyo, Japan
Shunji Yoshikawa
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
Yasuhiro Maejima
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
Mitsuaki Isobe
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan

Keywords: endovascular treatment, superficial femoral artery total occlusion, retrograde approach, popliteal puncture

JOURNAL FREE ACCESS

2015 Volume 8 Issue 3 Pages 220-226

DOI https://doi.org/10.3400/avd.oa.15-00025

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Abstract

Objective: Endovascular treatment (EVT) using a popliteal approach is effective for superficial femoral artery (SFA) chronic total occlusion (CTO); however, its effectiveness, safety, and consequent complications are unclear.Materials and Methods: We studied 324 consecutive EVTs (in 187 patients) performed at three centers between April 2008 and March 2013, and selected all EVTs that included SFA CTO regions. A total of 91 EVTs (in 65 patients) were included and divided into two groups; “with popliteal approach” (WPA) and “without popliteal approach” (WOPA).Results: Despite higher rates of hypertension (WPA, 88.9% vs. WOPA, 69.1%; p = 0.04) and CTO length >200 mm (55.6% vs. 28.3%, respectively; p <0.01), the primary success rate was better in the WPA group (97.2% vs. 78.2%, respectively; p <0.01); however, both total complication rate and major complication rate were not significantly different.We compared popliteal puncture using a sheath and using a microcatheter alone. There were no significant differences between sheath and microcatheter use in terms of primary success rates (95.5% vs. 100%, respectively; p = 0.61) and puncture site complications (22.7% vs. 14.2%, respectively; p = 0.53).Conclusion: A popliteal approach improved the primary success rate of EVT for SFA CTO.

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