title: Antegrade approach for percutaneous interventions of ostial superficial femoral artery: outcomes from a prospective series of diabetic patients presenting with critical limb ischemia.
abstract: OBJECTIVE
  This is a prospective evaluation of percutaneous interventions (PTAs) performed by the antegrade femoral approach in diabetic patients with critical limb ischemia (CLI) and ostial superficial femoral artery (SFA) lesions.
  
  
  METHODS
  The puncture site was selected according to duplex scan analysis and physical examination (brachial, crossover, or antegrade). In cases of antegrade approach, a bare needle angiogram of the femoral bifurcation was performed in order to have an adequate distance (>2 cm) from the target lesion.
  
  
  RESULTS
  Between January 2010 and August 2011, 64 diabetic patients underwent PTA for ostial SFA lesions. Crossover or brachial approach was electively adopted in 19/64 (30%) patients. The antegrade bare needle angiogram was performed in the remaining 45/64 (70%) patients. In two patients, the vascular anatomy was considered not suitable for antegrade approach, and they were treated in crossover. Technical success was achieved in 38/45 (84%) of patients. During hospital stay, one patient had SFA stent thrombosis treated with urgent bypass grafting.
  
  
  CONCLUSIONS
  The antegrade approach can be safely performed in most patients presenting with CLI and ostial SFA lesions. The use of clinical and radiographic criteria correctly identifies patients with ostial SFA lesions suitable for an antegrade approach in 42/44 (95%) of cases.
authors: Cardiovascular Department, Multimedica IRCCS, Sesto San Giovanni (MI), Italy. flavio.airoldi@multimedica.it
authors: Flavio
authors: F
authors: Airoldi
authors: Ezio
authors: E
authors: Faglia
authors: Sergio
authors: S
authors: Losa
authors: Davide
authors: D
authors: Tavano
authors: Azeem
authors: A
authors: Latib
authors: Gaetano
authors: G
authors: Lanza
authors: Giacomo
authors: G
authors: Clerici
mesh_terms: D017130:Angioplasty / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000503:physiopathology / Q000628:therapy*; D048909:Diabetes Complications / Q000628:therapy*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007511:Ischemia / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D016491:Peripheral Vascular Diseases / Q000601:surgery*; D011446:Prospective Studies; D011859:Radiography; D016896:Treatment Outcome