title: Popliteal versus tibial retrograde access for subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) technique.
abstract: OBJECTIVE
  This study aimed to ascertain differences in benefit and effectiveness of popliteal versus tibial retrograde access in subintimal arterial flossing with the antegrade-retrograde intervention (SAFARI) technique.
  
  
  METHODS
  This was a retrospective study of SAFARI-assisted stenting for long chronic total occlusion (CTO) of TASC C and D superficial femoral lesions. 38 cases had superficial femoral artery lesions (23 TASC C and 15 TASC D). All 38 cases underwent SAFARI-assisted stenting. The ipsilateral popliteal artery was retrogradely punctured in 17 patients. A distal posterior tibial (PT) or dorsalis pedis (DP) artery was retrogradely punctured in 21 patients, and 16 of them were punctured after open surgical exposure.
  
  
  RESULTS
  SAFARI technical success was achieved in all cases. There was no significant difference in 1-year primary patency (75% vs. 78.9%, p = .86), secondary patency (81.2% vs. 84.2%, p = .91) and access complications (p = 1.00) between popliteal and tibial retrograde access. There was statistical difference in operation time between popliteal (140.1 ± 28.4 min) and tibial retrograde access with PT/DP punctures after surgical vessel exposure (120.4 ± 23.0 min, p = .04).
  
  
  CONCLUSIONS
  The SAFARI technique is a safe and feasible option for patients with infrainguinal CTO (TASC II C and D). The PT or DP as the retrograde access after surgical vessel exposure is a good choice when using the SAFARI technique.
authors.affiliation: Department of Vascular Surgery, Shandong Provincial Hospital, Shandong University, Jinan, China; Department of Vascular Surgery, Jinan Central Hospital, Shandong University, Jinan, China.
authors.forename: W R
authors.initials: WR
authors.lastname: Hua
authors.forename: M Q
authors.initials: MQ
authors.lastname: Yi
authors.forename: T L
authors.initials: TL
authors.lastname: Min
authors.forename: S N
authors.initials: SN
authors.lastname: Feng
authors.forename: L Z
authors.initials: LZ
authors.lastname: Xuan
authors.forename: J
authors.initials: J
authors.lastname: Xing
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002406:Catheterization, Peripheral / Q000009:adverse effects; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D011677:Punctures; D011859:Radiography; D012189:Retrospective Studies; D015607:Stents; D016909:Tibial Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: Popliteal artery; Retrograde access; Stent; Subintimal; Tibial artery