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Retrograde Femoral Access for Difficult Superficial Femoral Artery Occlusions 

Retrograde Femoral Access for Difficult Superficial Femoral Artery Occlusions
Retrograde Femoral Access for Difficult Superficial Femoral Artery Occlusions

Luke E. Sewall

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date: 29 July 2021

Obtaining retrograde femoral access is a novel approach to treat difficult chronic total occlusions of the femoral arteries. The technique involves direct ultrasound-guided puncture of the mid to proximal superficial femoral artery. Using this access, a guidewire is advanced in a retrograde manner into the patent femoral or iliac artery above. This wire is then snared and brought out the contralateral sheath to allow safe access into the occluded vessel. The recanalization procedure can then be completed in a standard fashion. This technique is extremely useful in flush occlusions of the superficial femoral artery origin or in occluded stents, both of which often have very difficult proximal caps. This chapter outlines the details of this unusual technique.

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