title: Comparison of transfemoral vs transbrachial approach for angioplastic reconstruction of chronic total aortoiliac occlusion.
abstract: The angioplasty of chronic total aortoiliac occlusion using transfemoral is controversial. From March 2014 to December 2015, four consecutive patients (4 males; mean age 58.2±6.8 years; age of range 51-65 years) underwent angioplasty and stenting of TASC-D occlusion. In all the cases, we failed to cross from femoral approach. On switching over to left brachial access, angioplasty was done successfully in all. There was no procedural site complication or clinical evidence cerebral thromboembolism. Self-expandable stents were implanted in all with adequate pre and post dilation. Complete revascularisation was achieved in two cases and in other two cases, the angioplasty to the left aortoiliac carina was staged. Therefore, it is better to avoid femoral approach as initial step to cross chronic TASC 2007 type D (chronic total aortoiliac occlusion or called extensive aortoiliac disease) because of failure to cross retrogradely due to subintimal course of guide wire leading to retrograde aortic dissection.
authors.affiliation: Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad 500082, Telengana, India.
authors.forename: Sheshagiri Rao
authors.initials: SR
authors.lastname: Damera
authors.affiliation: Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad 500082, Telengana, India.
authors.forename: Ramachandra
authors.initials: R
authors.lastname: Barik
authors.affiliation: Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad 500082, Telengana, India.
authors.forename: Akula Siva
authors.initials: AS
authors.lastname: Prasad
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000379:methods*; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D005263:Femoral Artery; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015607:Stents; D017211:Treatment Failure
keywords: Angioplasty; Aortoiliac occlusion; Brachial approach; Femoral approach