Traditionally, isolated lesions in the ostium or proximal segment of the superficial femoral artery (SFA) have been approached angiographically either from the axillary route or, preferably, from the contralateral side. However, if the artery has multiple lesions, it is necessary to use a very long angioplasty catheter for one of the usual angiographic approaches or to do a downstream puncture with initial dilatation of the proximal or ostial lesion and subsequent dilatation of the distal lesions. This latter approach requires that the distal catheter manipulations occur across the dilated proximal segment, with an associated risk of extending a complicating intimal flap or detaching partially attached intimal plaques. We describe a technical modification that facilitates downstream angioplasty of distal lower-extremity lesions in patients with associated proximal disease.
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine