Objective: This study aimed to ascertain differences in benefit and effectiveness of popliteal versus tibial retrograde access in subintimal arterial flossing with the antegrade-retrograde intervention (SAFARI) technique. Methods: This was a retrospective study of SAFARI-assisted stenting for long chronic total occlusion (CTO) of TASC C and D superficial femoral lesions. 38 cases had superficial femoral artery lesions (23 TASC C and 15 TASC D). All 38 cases underwent SAFARI-assisted stenting. The ipsilateral popliteal artery was retrogradely punctured in 17 patients. A distal posterior tibial (PT) or dorsalis pedis (DP) artery was retrogradely punctured in 21 patients, and 16 of them were punctured after open surgical exposure. Results: SAFARI technical success was achieved in all cases. There was no significant difference in 1-year primary patency (75% vs. 78.9%, p = .86), secondary patency (81.2% vs. 84.2%, p = .91) and access complications (p = 1.00) between popliteal and tibial retrograde access. There was statistical difference in operation time between popliteal (140.1 +/- 28.4 min) and tibial retrograde access with PT/DP punctures after surgical vessel exposure (120.4 +/- 23.0 min, p = .04). Conclusion: The SAFARI technique is a safe and feasible option for patients with infrainguinal CTO (TASC II C and D). The PT or DP as the retrograde access after surgical vessel exposure is a good choice when using the SAFARI technique. (C) 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
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Univ Virginia, Dept Radiol, Charlottesville, VA 22903 USAUniv Virginia, Dept Radiol, Charlottesville, VA 22903 USA
Hendricks, Nicholas J.
Sabri, Saher S.
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Univ Virginia, Univ Virginia Hlth Syst, Dept Radiol, Div Intervent Radiol, 1215 Lee St, Charlottesville, VA 22903 USAUniv Virginia, Dept Radiol, Charlottesville, VA 22903 USA
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Univ Edinburgh, Fac Med, Edinburgh, Midlothian, ScotlandUniv Edinburgh, Fac Med, Edinburgh, Midlothian, Scotland
Kaushal, Anish
Roche-Nagle, Graham
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Univ Toronto, Univ Hlth Network, Div Vasc Surg, Toronto Gen Hosp, Toronto, ON, Canada
Univ Toronto, Univ Hlth Network, Div Intervent Radiol, Toronto Gen Hosp, Toronto, ON, CanadaUniv Edinburgh, Fac Med, Edinburgh, Midlothian, Scotland
Roche-Nagle, Graham
Tan, Kong T.
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Univ Toronto, Univ Hlth Network, Div Intervent Radiol, Toronto Gen Hosp, Toronto, ON, CanadaUniv Edinburgh, Fac Med, Edinburgh, Midlothian, Scotland
Tan, Kong T.
Liao, Elizabeth
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Univ Toronto, Fac Med, Toronto, ON, CanadaUniv Edinburgh, Fac Med, Edinburgh, Midlothian, Scotland
Liao, Elizabeth
Eisenberg, Naomi
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Univ Toronto, Univ Hlth Network, Div Vasc Surg, Toronto Gen Hosp, Toronto, ON, CanadaUniv Edinburgh, Fac Med, Edinburgh, Midlothian, Scotland
Eisenberg, Naomi
Oreopoulos, George D.
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Univ Toronto, Univ Hlth Network, Div Vasc Surg, Toronto Gen Hosp, Toronto, ON, Canada
Univ Toronto, Univ Hlth Network, Div Intervent Radiol, Toronto Gen Hosp, Toronto, ON, CanadaUniv Edinburgh, Fac Med, Edinburgh, Midlothian, Scotland
Oreopoulos, George D.
Rajan, Dheeraj K.
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Univ Toronto, Univ Hlth Network, Div Intervent Radiol, Toronto Gen Hosp, Toronto, ON, CanadaUniv Edinburgh, Fac Med, Edinburgh, Midlothian, Scotland