What is it about?
In this article we describe a novel bail-out technique for the endovascular repair of a lower extremity arterial occlusion. This technique is a modified SAFARI (Subintimal Arterial Flossing Antegrade Retrograde Intervention) procedure that allows successful revascularization when one or both of the bidirectional catheter exits the vessel entirely and is no longer intraluminal or subintimal. The operator directs a percutaneous needle through two snares at the site of occlusion and uses the needle to pass a wire that is grasped by both snares allowing through and through access for subsequent angioplasty and stenting.
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Why is it important?
Without this method, exit from the vessel during an endovascular revascularization frequently results in a technical failure. This procedure overcomes the limitations of conventional technique.
Perspectives
I was impressed at the relative ease with which we accomplished this procedure. With prior bidirectional (antegrade and retrograde) procedures, the catheters must be brought in close proximity to one another. This is usually accomplished with little difficulty, but some occlusions can be quite challenging and the catheters from one or both access sites become extravascular. This technique allows you to connect the two accesses even when the catheters lie a substantial distance from one another.
Dr. Sidney L Kahn
Read the Original
This page is a summary of: Extravascular Revascularization of a Chronic Total Occlusion Using the Dual Bull’s-Eye Technique, Journal of Endovascular Therapy, September 2016, SAGE Publications,
DOI: 10.1177/1526602816667307.
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