title: Successful extra-anatomical recanalization of occluded superficial femoral arteries using the Outback device--a report of 2 cases.
abstract: BACKGROUND
  We report 2 cases where the Outback catheter facilitated extra-anatomical bypass after vessel perforation during attempted subintimal vessel dissection.
  
  
  METHODS
  Attempted subintimal angioplasty of the superficial femoral artery (SFA) resulted in vessel perforation in 2 patients with chronic SFA occlusion and limb ischemia. Due to the lack of other endovascular or surgical options, the Outback catheter was used to reenter the patent lumen distal to the perforation. A stent graft was then deployed from proximal to the perforation to beyond the reentry point with successful outcomes.
  
  
  CONCLUSIONS
  Although the reentry devices are typically used to enter the lumen from the subintimal plane, this novel technique involves using the Outback catheter to enter from the extravascular compartment and facilitate bypass of the SFA occlusion via an extra-anatomical route. This novel technique can be used to restore in-line blood flow when attempted endovascular revascularization failed due to vessel perforation.
authors.affiliation: Department of Radiology, Nottingham University Hospitals NHS Trust, Queens Medical Centre, Nottingham, UK.
authors.forename: James
authors.initials: J
authors.lastname: Kirk
authors.forename: Richard
authors.initials: R
authors.lastname: Wilson
authors.forename: Flora
authors.initials: F
authors.lastname: Kovacs
authors.forename: William
authors.initials: W
authors.lastname: Tennant
authors.forename: Bruce
authors.initials: B
authors.lastname: Braithwaite
authors.forename: Said
authors.initials: S
authors.lastname: Habib
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation*; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D057785:Catheters; D003251:Constriction, Pathologic; D004867:Equipment Design; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000293:injuries; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016879:Salvage Therapy; D015607:Stents; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*