Which Intervention Method Should be Chosen for Superficial Femoral Artery Balloon Angioplasty: Antegrade or Retrograde? A Single-Centre Experience
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Objectives: To determine which method is preferable for intervention in superficial femoral artery (SFA) lesions and has a lower risk of complications. Materials and Methods: During the first six months of 2021, 153 patients undergoing peripheral angiography for an arterial origin were retrospectively reviewed. Thus, 97 peripheral angiographic procedures in 82 patients were included in this study. Complications after the procedure were evaluated. Results: The median age of the patients was 62 years (interquartile range 41-89 years). Ninety-seven procedures were performed: 37.1% were antegrade procedures and 62.9% were retrograde procedures. There was no significant difference in patients who underwent surgery on both legs in terms of chronic disease (p>0.05). Dissection was observed in 3 patients undergoing antegrade SFA procedures. Although retrograde procedures were performed more frequently, no flow-restricting dissection was observed. Hematomas formed after angioplasty in 5 patients who underwent antegrade procedures. An arteriovenous (AV) fistula developed in 2 patients. AV no fistula was observed in patients who underwent retrograde surgery. However, four patients had pseudoaneurysms and two patients had hematomas. In all these patients, puncture was performed below the gastrocnemius muscle. No hematoma or pseudoaneurysm was observed in any of the patients operated on over the gastrocnemius muscle. In both procedures, dissection was higher in patients with occlusion than in those without occlusion, which was statistically significant (p<0.05). Conclusion: Because retrograde procedures are performed against the direction of flow, it was observed that the flap was mostly closed in controls even if dissection occurred. Retrograde puncture via the gastrocnemius muscle may reduce the incidence of hematoma and pseudoaneurysms. The reason for not seeing fistulas in retrograde punctures could be the effective use of ultrasonography in this area. Retrograde intervention might be preferable in this case, especially because dissection is more common in occlusions.
Açıklama
Anahtar Kelimeler
Antegrade, retrograde, balloon angioplasty
