Retrograde Crossing of Occluded Common Femoral Artery Using Deep Femoral Artery Access and Outback re-entry
Dawn M. Olsen, DO, Mariel Rivero, MD, Hasan H. Dosluoglu, MD.
SUNY at Buffalo, Buffalo, NY, USA.
Purpose: to present a previously unreported case of retrograde recanalization of calcific common femoral artery (CFA) occlusion via deep femoral artery (DFA) access using Outback re-entry device. Case report: A 75-year-old male with severe CAD, presented with rest pain and was found to have right CFA occlusion with reconstitution of DFA. Femoral endarterectomy/profundoplasty was planned, however upon induction, he developed ST changes and the procedure was aborted. After re-optimization of his nonreconstructable coronary artery disease, he was offered percutaneous intervention. Initial antegrade crossing attempt was unsuccessful due to severe calcification, so right DFA was accessed under fluoroscopic guidance, but the wire did not reenter the external iliac artery. Outback re-entry catheter was used after placing 6F sheath to DFA, to reenter preserving the large collateral branches and the wire was retrieved from the contralateral sheath. Balloon angioplasty of the CFA with 5mm x 6cm balloon was successful, with brisk flow to DFA with resolution of symptoms. Conclusion: Percutaneous retrograde recanalization of an occluded CFA via DFA access with or without reentry device use is feasible and safe and can be considered in high risk patients.
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