title: Novel retrograde puncture technique for infrapopliteal artery revascularization: transplantar retrograde access.
abstract: Patients with critical limbs ischemia received endovascular revascularization for his posterior tibial artery (PTA) to plantar artery long occlusion without proximal stump. Antegrade recanalization seemed impossible, so retrograde access should be considered. However, the conventional retrograde puncture was also not available. Therefore, novel retrograde transplantar access was conducted. The plantar artery was successfully punctured with a 20-G needle. In addition, a guidewire was retrogradely inserted with a sheathless technique. Finally, it was retrogradely crossed the occluded lesion. The final angiogram showed sufficient results. Transplantar retrograde access was feasible technique for infrapopliteal EVT, when the conventional antegrade and retrograde approaches were not available.
authors: Miyazaki Medical Association Hospital, Cardiovascular Center, Funato 738-1, Shinbeppu-tyo, Miyazaki, Japan. tatsuya_nakama@med.miyazaki-u.ac.jp.
authors: Tatsuya
authors: T
authors: Nakama
authors: Department of Cardiology, Kasukabe Chuo General Hospital, Saitama, Japan.
authors: Hiroshi
authors: H
authors: Ando
authors: Miyazaki Medical Association Hospital, Cardiovascular Center, Funato 738-1, Shinbeppu-tyo, Miyazaki, Japan.
authors: Nozomi
authors: N
authors: Watanabe
authors: Miyazaki Medical Association Hospital, Cardiovascular Center, Funato 738-1, Shinbeppu-tyo, Miyazaki, Japan.
authors: Kenji
authors: K
authors: Ogata
authors: Miyazaki Medical Association Hospital, Cardiovascular Center, Funato 738-1, Shinbeppu-tyo, Miyazaki, Japan.
authors: Tatsuro
authors: T
authors: Takei
authors: Miyazaki Medical Association Hospital, Cardiovascular Center, Funato 738-1, Shinbeppu-tyo, Miyazaki, Japan.
authors: Yoshisato
authors: Y
authors: Shibata
mesh_terms: D000369:Aged, 80 and over; D017719:Diabetic Foot / Q000628:therapy; D057510:Endovascular Procedures / Q000379:methods*; D005528:Foot / Q000098:blood supply; D006801:Humans; D008297:Male; D058729:Peripheral Arterial Disease / Q000628:therapy*; D011150:Popliteal Artery; D011677:Punctures
keywords: Chronic total occlusion; Critical limbs ischemia; Endovascular therapy; Limbs salvage; Peripheral arterial diseases; Retrograde approach