scholarly journals Superficial femoral artery stenting via radial access using R2P® Misago® stents: First-in-human report of the new R2P® system

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984734
Author(s):  
Norihiko Shinozaki ◽  
Yuji Ikari
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
External Iliac Artery ◽  
Limb Ischemia ◽  
Below The Knee ◽  
Shaft System ◽  
Rapid Exchange ◽  
Stent System ◽  
The Right ◽  
Guiding Catheter

A 73-year-old male with left critical limb ischemia was scheduled to undergo below-the-knee amputation. Prior to the amputation, he was referred to our institute for endovascular treatment. We inserted the new 7-Fr 150-cm-long guiding catheter, SlenGuide®, into the external iliac artery from the right radial artery with the 7-Fr Glidesheath Slender®. We implanted two R2P® Misago® stents with rapid-exchange, 200-cm-long shaft system in the stenosis of the left superficial femoral artery. This new stent system involves rapid-exchange and a long shaft system; furthermore, it is useful in transradial stenting in the superficial femoral artery.

scholarly journals Alternative Combined Retrograde–Antegrade Use of a Re-entry Device in the Revascularization of a Surgically Ligated Superficial Femoral Artery Occlusion

2021 ◽  
Vol 5 (01) ◽  
pp. 62-65
Author(s):  
Roberto Gandini ◽  
Armando Raso ◽  
Arezia Di Martino ◽  
Fabio Salimei ◽  
Daniele Morosetti
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Limb Ischemia ◽  
Artery Occlusion ◽  
Covered Stent ◽  
Foot Ulcers ◽  
Surgical Closure ◽  
Femoral Artery Occlusion ◽  
The Right ◽  
Occluded Segment

AbstractWe report a case of a diabetic patient with critical limb ischemia, who previously underwent thromboendarterectomy at the right lower extremity, resulting in surgical ligation at the proximal third of the right superficial femoral artery (SFA). Twenty months later, the patient developed foot ulcers; endovascular treatment was therefore performed. After obtaining a retrograde right SFA subintimal access, directly puncturing the occluded segment of the artery, a re-entry intravascular ultrasound-guided catheter was used to gain proximal re-entry. Then, the same device was used again, in antegrade fashion, to obtain re-entry into the patent popliteal artery. A covered stent was deployed in the site of the surgical closure. In the following 3 months, foot ulcers healed.

scholarly journals Early Detection of Post-Endarterectomy Complication by Point-of-Care Ultrasound

Reports ◽  
2021 ◽  
Vol 4 (3) ◽  
pp. 21
Author(s):  
Bo-Ku Chen ◽  
Po-Wei Chiu ◽  
Chih-Hao Lin
Keyword(s):  
Femoral Artery ◽  
Point Of Care ◽  
Postoperative Bleeding ◽  
External Iliac Artery ◽  
Common Femoral Artery ◽  
Atheromatous Plaque ◽  
Point Of Care Ultrasound ◽  
Related Complication ◽  
Contrast Extravasation ◽  
The Right

Endarterectomy is an effective intervention to remove the atheromatous plaque in the inner lining of the artery, aiming to revascularize the occluded/stenosed vessel in patients with peripheral arterial occlusive disease (PAOD). The most common wound-related complication is postoperative bleeding, followed by infection, hematoma, and seroma. However, hematoma complications with air surrounded have rarely been reported in clinical cases. Case presentation: A 90-year-old female patient visited our emergency department because of a rapidly growing hematoma with pulsatile bleeding over her right groin area. She had received bilateral percutaneous transluminal angioplasty with endarterectomy for PAOD one month prior. A point-of-care ultrasound revealed a large hypoechoic mass, with a dirty shadow on the right groin area. Computed tomography angiography showed a hematoma over her right femoral region, with free air surrounding the right femoral artery. Angiography revealed an irregular shaped lesion on the right femoral artery without contrast extravasation. The patient was diagnosed with right-femoral post-endarterectomy infection with infected hematoma, with the inclusion of air. She underwent urgent excision and repair of the right femoral artery infectious lesion, debridement of the infectious hematoma and stenting of the right external iliac artery, common femoral artery and superficial femoral artery.

scholarly journals Healing of femoral artery dissection after drug-coated balloon angioplasty: A case report with intravascular ultrasonography and angioscopy images

2019 ◽  
Vol 7 ◽  
pp. 2050313X1983415
Author(s):  
Taketsugu Tsuchiya ◽  
Minako Oda ◽  
Takaaki Takamura ◽  
Katsuhide Kitagawa ◽  
Koji Kajinami ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Balloon Angioplasty ◽  
Iliac Artery ◽  
Superficial Femoral Artery ◽  
External Iliac Artery ◽  
Artery Dissection ◽  
Intravascular Ultrasonography ◽  
Stent Deployment ◽  
Atherosclerotic Stenosis ◽  
Drug Coated Balloon

Early 80s male with intermitted claudication underwent endovascular therapy for atherosclerotic stenosis at left external iliac artery and middle of superficial femoral artery. Patient also had chronic atrial fibrillation, diabetes mellitus, and hypertension. After stent deployment for external iliac artery lesion, a short superficial femoral artery lesion was performed with angioplasty using drug-coated balloon. The drug-coated balloon angioplasty resulted in 50% residual stenosis with linear dissection; however, provisional stenting was not performed as decent ante-grade blood flow allowed 10 extra minutes. Medication involved ongoing use of aspirin 100 mg and rivaroxaban 15 mg. Angiography post 3 months from index procedure showed external iliac artery and superficial femoral artery patency and healing of intimal dissection at superficial femoral artery lesion was estimated by intravascular ultrasonography. In angioscopy findings, red thrombus was seen in dissection cavity.

scholarly journals Endovascular therapy for severely calcified plaque at the superficial femoral artery using myocardial biopsy forceps

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Shojiro Hirano ◽  
Atsushi Funatsu ◽  
Shigeru Nakamura ◽  
Takanori Ikeda
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Calcium Score ◽  
Biopsy Forceps ◽  
Myocardial Biopsy ◽  
Deep Femoral Artery ◽  
Total Occlusion ◽  
Stent Expansion ◽  
Calcified Plaque ◽  
The Right

Abstract Background Currently, the success rate of EVT for treating CTO of the SFA is high; however, EVT is still found to be insufficient in treating CTOs with severely calcified lesions. Even if the guidewire crosses the lesion, the calcifications may still cause difficulties during stent expansion. Main text A 78-year-old male had been reported to have intermittent claudication with chronic total occlusion (CTO) of the right superficial femoral artery (SFA). Angiography revealed severely calcified plaque (Angiographic calcium score: Group4a [1]) at the ostium of the SFA. Stenting posed a risk of underexpansion, causing the plaque to shift to the deep femoral artery. we decided to remove the calcified plaque using biopsy forceps. After removing the extended calcified plaque, the guidewire could cross easily, and the self-expandable stent was well dilated without causing the plaque to shift to the DFA. Conclusions Biopsy forceps may be used in some endovascular cases to remove severely calcified lesions. To ensure the safety of the patient, the physician must be adept at performing this technique before attempting it.

Antegrade vs Crossover Femoral Artery Access in the Endovascular Treatment of Isolated Below-the-Knee Lesions in Patients With Critical Limb Ischemia

2017 ◽  
Vol 24 (3) ◽  
pp. 331-336 ◽  
Author(s):  
Yukun Li ◽  
Ali Esmail ◽  
Konstantinos P. Donas ◽  
Georgios Pitoulias ◽  
Giovanni Torsello ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Success Rate ◽  
Femoral Artery ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Technical Success ◽  
Femoral Access ◽  
Technical Success Rate ◽  
Below The Knee ◽  
Antegrade Approach

Purpose: To evaluate the safety and effectiveness of antegrade vs crossover femoral artery access in the endovascular treatment of isolated below-the-knee (BTK) lesions in patients with critical limb ischemia (CLI). Methods: Between January 2014 and December 2015, 224 high-risk patients (mean age 75.8±9.8 years; 151 men) with CLI underwent infragenicular interventions on 292 crural vessels in 3 European vascular centers. All patients had isolated TransAtlantic Inter-Society Consensus (TASC) C (n=26) or D (n=198) BTK lesions. Primary endpoints were freedom from access-related complications and technical success comparing the antegrade vs crossover access groups. Results: Balloon angioplasty was the most used treatment modality (169 vessels, 75.4%). The technical success rate was 88.4% in the entire cohort and 88.0% in the antegrade group vs 90.4% in the crossover group (p>0.99). In all patients, the technical success rate was higher for stenotic lesions (100%) vs occlusions (85.5%, p=0.002) and in patients with TASC C BTK lesions (100%) vs TASC D (86.9%, p=0.033). The overall freedom from access-related complications was 97.8%: 99% in the antegrade group and 90.6% in the crossover group (p=0.022). Larger sheath size (5/6-F vs 4-F) was associated with a significantly higher risk for access-related complications (7.1% vs 1.1%, respectively; p=0.047). Conclusion: The present multicenter study showed high technical success and a low incidence of access-related complications in the treatment of isolated BTK lesions using either antegrade or crossover femoral access. The antegrade approach with the use of a 4-F system seems to have a significantly lower rate of access-related complications.

Femoral Artery Branch Pseudoaneurysm Resulting From Muscle Strain Injury

2021 ◽  
pp. 154431672110304
Author(s):  
Besnike Kashtanjeva
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Ultrasound Examination ◽  
Muscle Strain ◽  
Vigorous Exercise ◽  
The Right ◽  
Muscle Strain Injury ◽  
Artery Branch

A 66-year-old male presented with pain and swelling isolated to the right thigh after a bout of vigorous exercise on a step treadmill. We report a muscle strain injury resulting in formation of a pseudoaneurysm arising from a branch of the mid superficial femoral artery. The pseudoaneurysm was incidentally discovered during a venous ultrasound examination. Within 2 weeks of its finding, the pseudoaneurysm had resolved.

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

2019 ◽  
Vol 26 (4) ◽  
pp. 490-495 ◽  
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.

scholarly journals Sustained drug retention after paclitaxel-coated balloon angioplasty for superficial femoral artery disease: Follow-up intravascular imaging

2020 ◽  
Vol 8 ◽  
pp. 2050313X2090782
Author(s):  
Norihiro Kobayashi ◽  
Keisuke Hirano ◽  
Masahiro Yamawaki ◽  
Motoharu Araki ◽  
Tsuyoshi Sakai ◽  
...  
Keyword(s):  
Frequency Domain ◽  
Femoral Artery ◽  
Balloon Angioplasty ◽  
Superficial Femoral Artery ◽  
Optical Frequency ◽  
Optical Frequency Domain Imaging ◽  
Drug Retention ◽  
Artery Disease ◽  
The Right

A 63 year-old woman with claudication underwent endovascular therapy for diffuse stenosis of the right superficial femoral artery in our hospital. We performed paclitaxel-coated balloon angioplasty using the IN.PACT™ Admiral™ and achieved acceptable results. After 42 days, we performed follow-up optical frequency domain imaging for the right superficial femoral artery lesion treated with paclitaxel-coated balloon and observed several high-intensity regions with attenuation on the lumen surface. Sustained drug availability is a notable characteristic of paclitaxel-coated balloon. To the best of our knowledge, this is the first report on the visualization of sustained drug retention on the lumen surface using follow-up optical frequency domain imaging after paclitaxel-coated balloon angioplasty in a human patient with superficial femoral artery disease.

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