Feasibility and Safety of Vascular Closure Devices in an Antegrade Approach to Either the Common Femoral Artery or the Superficial Femoral Artery

Ostial lesions of the superficial femoral artery preclude the use of ipsilateral common femoral artery antegrade approach. Access via either the contralateral common femoral or the brachial arteries are the 2 alternative classical approaches. Conversely, using an ipsilateral antegrade approach, through a partially inserted sheath, usually leaves the sheath insecure and frequently hits ostial lesion itself during insertion. Dislodgment from the artery frequently occurs, resulting in loss of access. We describe a technique whereby we insert 2 to 3 cm of the sheath into the common femoral artery and the remaining part of the sheath resides in a fashioned subcutaneous tunnel of the lowermost abdomen. Technical details are provided as well as the results of using this technique on 37 patients. The technique is safe, easy to perform, and reproducible.

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Femoral Balloon-Oriented Puncture for True Lumen Reentry in the Common Femoral Artery After Subintimal Retrograde Recanalization of Superficial Femoral Artery Ostial Occlusion: The FORLEE Technique

Journal of Endovascular Therapy ◽

10.1177/1526602819849722 ◽

2019 ◽

Vol 26 (4) ◽

pp. 490-495 ◽

Cited By ~ 1

Author(s):

Gabriele Testi ◽

Tanja Ceccacci ◽

Mauro Cevolani ◽

Francesco Giacchi ◽

Fabio Tarantino ◽

...

Keyword(s):

Femoral Artery ◽

Superficial Femoral Artery ◽

Balloon Catheter ◽

Duplex Ultrasound ◽

Cost Effective ◽

Limb Ischemia ◽

Common Femoral Artery ◽

Anterior Tibial Artery ◽

True Lumen ◽

The Common

Purpose: To report a new technique to reenter the common femoral artery (CFA) true lumen after retrograde recanalization of a superficial femoral artery (SFA) with flush ostial occlusion. Technique: The technique is demonstrated in a 76-year-old woman with critical limb ischemia previously submitted to several surgical revascularizations. A duplex ultrasound showed flush ostial occlusion of the SFA and patency of the anterior tibial artery at the ankle as the sole outflow vessel. After unsuccessful antegrade attempts to recanalize the SFA, a retrograde guidewire was advanced subintimally up to the CFA, without gaining reentry. A balloon catheter was inflated in the subintimal plane across the SFA ostial occlusion. Antegrade access to the distal CFA was achieved with a 20-G needle, which was used to puncture the balloon. A guidewire was advanced into the balloon and pushed forward while the collapsed balloon was pulled back to the mid SFA. The antegrade guidewire was externalized through a retrograde catheter, which was pushed in the CFA true lumen. A retrograde guidewire was advanced and externalized through the femoral sheath, establishing a flossing wire. The procedure was completed in antegrade fashion. Conclusion: The FORLEE technique is a cost-effective option to gain the CFA true lumen after subintimal retrograde recanalization of an ostial SFA occlusion.

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ULSOSEAL Technique: A Unique Technique to Achieve Hemostasis Using ExoSeal in High-Risk Patients after Common Femoral Artery Puncture

Journal of Interventional Cardiology ◽

10.1155/2021/2470333 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Yohsuke Honda ◽

Shinsuke Mori ◽

Tomoya Fukagawa ◽

Toshihiko Kishida ◽

Takahide Nakano ◽

...

Keyword(s):

High Risk ◽

Femoral Artery ◽

Common Femoral Artery ◽

Puncture Site ◽

Vessel Occlusion ◽

Antegrade Approach ◽

Secondary Bleeding ◽

Risk Patients ◽

The Common ◽

Severe Calcification

This study aimed to assess the safety and feasibility of the ULtrasound-guided uSe Of exoSEAL technique (ULSOSEAL technique) in patients at a high risk of complications following the use of ExoSeal. ExoSeal is a novel, completely extravascular hemostatic device that can treat punctures of the common femoral artery; however, it is not preferable for use in cases that require hemostasis of complex puncture sites. From November 2019 to August 2020, the ULSOSEAL technique was performed in 35 patients with implanted stents (6 patients, 17%), severe calcification (32 patients, 91%), and plaque (7 patients, 20%) around the puncture site; the presence of these conditions is usually undesirable when using ExoSeal. The antegrade approach was used in 22 patients (71%). The size of the ExoSeal used was 5 Fr (13 patients, 37%), 6 Fr (21 patients, 60%), and 7 Fr (1 patient, 2%). Technical success was achieved in 34 patients (97%), while ExoSeal malfunction occurred in 1 patient. There was no incidence of vessel occlusion, pseudoaneurysm, arteriovenous fistula, infection, and secondary bleeding. One patient developed a hematoma (>5 cm in size); however, it occurred before the use of ExoSeal due to side leakage from the inserted sheath. The ULSOSEAL technique was safe and feasible for hemostasis in patients who were considered unsuitable for the ExoSeal device.

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A Combined Radial and Pedal Access to Treat a Flush Chronic Total Occlusion of the Superficial Femoral Artery in a Critical Limb Ischemia Patient

Open Journal of Cardiovascular Surgery ◽

10.1177/1179065219834523 ◽

2019 ◽

Vol 11 ◽

pp. 117906521983452

Author(s):

Nicolas W Shammas ◽

Qais Radaideh

Keyword(s):

Femoral Artery ◽

Critical Limb Ischemia ◽

Superficial Femoral Artery ◽

Chronic Total Occlusion ◽

Limb Ischemia ◽

Common Femoral Artery ◽

Retrograde Approach ◽

Total Occlusion ◽

Radial Approach ◽

Antegrade Approach

We present a case of a flush chronic total occlusion of the superficial femoral artery treated successfully with a combined antegrade approach using radial access and a retrograde approach using a pedal access. Patient has total occlusion of the contralateral left external iliac and common femoral artery. Our case illustrates the feasibility of the combined pedal-radial approach in treating flush occlusions of the superficial femoral artery.

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Ultrasound-guided antegrade femoral access: comparison between the common femoral artery and the superficial femoral artery

European Radiology ◽

10.1007/s00330-010-2032-z ◽

2010 ◽

Vol 21 (6) ◽

pp. 1323-1328 ◽

Cited By ~ 22

Author(s):

A. Gutzeit ◽

N. Graf ◽

E. Schoch ◽

T. Sautter ◽

R. Jenelten ◽

...

Keyword(s):

Femoral Artery ◽

Superficial Femoral Artery ◽

Common Femoral Artery ◽

Ultrasound Guided ◽

Femoral Access ◽

The Common

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Initial Experience with Percutaneous Angioplasty of the Common Femoral Artery in De Novo Stenotic Lesions

Annals of Vascular Surgery ◽

10.1016/j.avsg.2015.05.002 ◽

2015 ◽

Vol 29 (8) ◽

pp. 1493-1500 ◽

Cited By ~ 11

Author(s):

Romain de Blic ◽

Jean-François Deux ◽

Hicham Kobeiter ◽

Pascal Desgranges ◽

Jean-Pierre Becquemin ◽

...

Keyword(s):

Femoral Artery ◽

De Novo ◽

Common Femoral Artery ◽

Initial Experience ◽

Percutaneous Angioplasty ◽

The Common ◽

Stenotic Lesions

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Anomalous High Bifurcation of the Common Femoral Artery at the Groin: Management of Gsv Incompetence with Endovenous Laser Ablation

Phlebology The Journal of Venous Disease ◽

10.1258/phleb.2012.012047 ◽

2012 ◽

Vol 28 (5) ◽

pp. 264-267 ◽

Cited By ~ 1

Author(s):

C Lekich ◽

W Campbell ◽

S Walton ◽

P Hannah

Keyword(s):

Laser Ablation ◽

Femoral Artery ◽

Vascular Complications ◽

Common Femoral Artery ◽

Vascular Anomalies ◽

Endovenous Laser Ablation ◽

Safe Treatment ◽

Complications Of Surgery ◽

The Common ◽

Saphenofemoral Junction

Objectives: To discuss safety of EVLA in anomalies of the GSV anatomy. To review and discuss complications of surgery involving anomalous anatomy. Method: We report a case of high bifurcation of the common femoral artery wrapping around the saphenofemoral junction. Results: Successful ablation was achieved with no adverse consequences. Conclusion: EVLA is a safe treatment for SFJ/GSV incompetence in the presence of vascular anomalies that have historically resulted in serious vascular complications from surgery.

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