title: Ultrasound-guided retrograde popliteal artery catheterization: experience in 174 consecutive patients.
abstract: OBJECTIVE
  To assess the safety and efficacy of ultrasound (US) guidance during retrograde popliteal artery catheterization (RPAC) and identify the risk factors for late hemostasis and complications.
  
  
  METHODS
  A retrospective review was undertaken of consecutive patients who underwent grayscale US-guided RPAC during the last 8 years. Chart review identified 174 patients (150 men; mean age 61+/-10 years, range 37-84) with 247 iliofemoral lesions, which were treated via US-guided RPAC. Complications were classified as puncture-related versus angioplasty-related and major versus minor. Risk factors for complications and late hemostasis were evaluated with logistic and linear regression analyses, respectively.
  
  
  RESULTS
  All 234 US-guided RPACs were technically successful. No arteriovenous fistula (AVF) or dissection/thrombosis of the popliteal artery was observed. The mean time to hemostasis was 6.9+/-2.3 minutes. The presence of femoral stenosis (versus occlusion) and use of large (6 to 7-F) sheaths were significant risk factors for late hemostasis. In 234 procedures, 15 (6.4%) complications developed; 10 (4.3%) were puncture-related (3 major, 7 minor) and 5 (2.1%) were angioplasty-related (3 major, 2 minor). Intra-arterial fibrinolysis was found to be the only significant risk factor for overall and puncture-related complications.
  
  
  CONCLUSIONS
  Our results suggest that US-guided RPAC is at least as safe as other RPAC methods described in the literature. In contrast to generally held concerns, hemostasis is easy to obtain, and multiple punctures and the use of large sheaths appear safe. These results should be taken into consideration during the selection of an access site for endovascular treatment of superficial femoral artery and tandem iliofemoral lesions.
authors.affiliation: Department of Radiology, Akdeniz University School of Medicine, Arapsuyu, Antalya, Turkey. ysaim@akdeniz.edu.tr
authors.forename: Saim
authors.initials: S
authors.lastname: Yilmaz
authors.forename: Timur
authors.initials: T
authors.lastname: Sindel
authors.forename: Ersin
authors.initials: E
authors.lastname: Lüleci
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005263:Femoral Artery; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery; D011183:Postoperative Complications; D011677:Punctures; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D018084:Ultrasonography, Interventional