Endovascular treatment of chronic total occlusion of superficial femoral artery using retrograde approach from popliteal artery

An 55 years-old man with intermittent claudication was admitted to Hue central Hospital. Doppler ultrasound and digital subtraction angiography showed his left superficial femoral artery (SFA) was chronic total occlusion (CTO), and we performed endovascular treatment (EVT). We advanced a guide-wire by contralateral transfemoral approach, but guide-wire could not penetrate the occluded SFA lesion antegradely. Thus, we tried to approach the CTO lesion retrogradely. A guide-wire passed from popliteal artery to distal SFA. With a reverse-controlled antegrade and retrograde approach technique, we were able to pass the CTO lesion. Finally, two stents were implanted. We experienced a case in which retrograde approach via collateral channel from popliteal artery was effective to CTO of SFA.