PMC4252330_01
A, B - Angiography from the left brachial artery revealed that right femoropopliteal bypass grafts were proximally occluded, native external iliac artery was occluded before giving superficial femoral artery branch, and the proximal part of the occlusion site could not be seen clearly. C - 6 Fr radial sheath was inserted to posteriortibial artery
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F0001
Angiography revealed that bilaterally the grafts were proximally occluded, the native external iliac artery was occluded before giving the superficial femoral artery branch, and the proximal part of the occlusion site could not be seen clearly (Figures 1A, B). Amplatz wire, and afterwards transpedal punction was performed. A 6 Fr radial sheath (Merit-Prelude) was inserted to the posteriortibial artery (Figure 1C). A 5 Fr STS catheter was advanced from the posterior tibial artery, and an unsuccessful attempt was made to penetrate the distal cap by Treasure Floppy Guide Wire.
A, B - Angiography from the right tibial posterior artery demonstrated subintimal tracking and re-entry to true lumen of the superficial femoral artery. C - Angiography shows successful balloon angioplasty
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Wire (Figures 2A, B). We tried to enter the guiding catheter advanced from the brachial artery in a retrograde manner, but we were unable to do this. A 4.0 mm x 60 mm balloon was advanced in an antegrade direction and predilatation was performed (Figure 2C). 7.0 mm x 210 mm, 6 mm x 40 mm self-expandable Polaris (Qualimed) stents were deployed successfully (Figures 3A, B).
A, B - An angiogram obtained from the catheter placed in the brachial artery showed complete recanalisation of the native femoropopliteal artery with angioplasty and stenting
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F0003
A 4.0 mm x 60 mm balloon was advanced in an antegrade direction and predilatation was performed (Figure 2C). 7.0 mm x 210 mm, 6 mm x 40 mm self-expandable Polaris (Qualimed) stents were deployed successfully (Figures 3A, B).