2. Vascular Surgery failed in an attempt to recanalize the left SFA in a patient with
limiting claudication. Occlusion extends from ostium to distal SFA.
Previous attempts included antegrade subintimal angioplasty with front-runner
device and attempts to re-enter with the outback device.
3. Given the previous attempts, we gained pedal access using
palpation (I’ve got sensitive fingers) and a Cook micropuncture
kit.
Wire was easily advance up to the occlusion
4. Both antegrade and retrograde wire were advanced. Both were subintimal.
We attempted re-entry at both the proximal and distal caps without success.
5. We therefore brought a 4.0mm balloon up from the foot and an outback down from
the femoral and punctured the balloon with the re-entry needle. We then brought
the wire into the balloon and pulled the balloon and wire through the occlusion. We
brought a balloon over the antegrade wire to confirm position.
6. We used a 4.0 and 6.0 balloon to predilate. We stented with iDev
Supera stents.
