SFA CTO WITH SAFARI TECHNIQUE

UTILIZING OUTBACK REENTRY

Luft MDEvans DO

Vascular Surgery failed in an attempt to recanalize the left SFA in a patient with limiting claudication. Occlusion extends from ostium to distal SFA.

Previous attempts included antegrade subintimal angioplasty with front-runner device and attempts to re-enter with the outback device.

Given the previous attempts, we gained pedal access using palpation (I’ve got sensitive fingers) and a Cook micropuncture kit.

Wire was easily advance up to the occlusion

Both antegrade and retrograde wire were advanced. Both were subintimal.

We attempted re-entry at both the proximal and distal caps without success.

We therefore brought a 4.0mm balloon up from the foot and an outback down from the femoral and punctured the balloon with the re-entry needle. We then brought the wire into the balloon and pulled the balloon and wire through the occlusion. We brought a balloon over the antegrade wire to confirm position.

We used a 4.0 and 6.0 balloon to predilate. We stented with iDev Supera stents.

FINAL RESULT IN THE SFA

FINAL RUNOFF