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Flip Techniques: Obtaining Antegrade and Retrograde Femoral Access Through a Single Access Site 

Flip Techniques: Obtaining Antegrade and Retrograde Femoral Access Through a Single Access Site
Chapter:
Flip Techniques: Obtaining Antegrade and Retrograde Femoral Access Through a Single Access Site
Author(s):

S. Lowell Kahn

DOI:
10.1093/med/9780199986071.003.0024
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date: 20 February 2020

Retrograde access of the common femoral artery for ipsilateral iliac and up-and-over contralateral iliac-to-tibial interventions has been the standard of care for lower extremity procedures. However, ipsilateral antegrade access has gained popularity for infrainguinal occlusive disease. Proximity of the access site to the point of occlusion confers a higher technical success rate. Interestingly, there are times where conversion of a single femoral access from retrograde to antegrade or antegrade to retrograde may be desired. Three techniques are reviewed in this chapter: the first technique involves using a reverse curve catheter in conjunction with a Glidewire. The second technique is a “rebound” method whereby a Fogarty catheter is inflated just beyond the tip of a retrograde sheath to deflect a side-by-side Glidewire in the opposite direction. The third technique describes converting an antegrade sheath back to retrograde using a “buddy wire.”

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