×
It looks like you're using an obsolete version of internet explorer. Internet explorer is no longer supported by Microsoft since the end of 2015. We invite you to use a newer browser such as Firefox, Google Chrome or Microsoft Edge.
My Player placeholder
Become an Incathlab member and receive full access to its content!
You must be an Incathlab member to access videos without any restrictions. Register for free in one minute and access all services provided by Incathlab.You will also be able to log into Incathlab from your Facebook or twitter account by clicking on login on the top-right corner of Incathlab website.
Registration Login
Registration Login
41399 views
This 20-minute case concerns a 70-year-old man with recent left intermittent claudication presenting a very long superficial femoral occlusion with no past endovascular procedure.
He is treated contra-laterally by subintimal recanalization and long femoral stenting.
Step-by-Step Procedure
- Presentation of the case, description of the angiography and the planned procedure
- Subintimal angioplasty initiation from contra-lateral approach
- Description of subintimal angioplasty and re-entry in the true lumen
- Pre-balloon angioplasty with long balloon (5.5 mm x 200 cm) and evaluation of results
- Selection and careful deployment of the first 20 cm long stent
- Stent shaft retrieval
- Vessel preparation and deployment of the second 15 cm long stent
- Assessment of the results after stenting
- Closing of the right femoral puncture site with a STARCLOSE device
Learning points
- Contra lateral approach of an occluded SFA from the ostium to the Hunter canal
- Initiating subintimal crossing with 0.035 inches hydrophilic guidewire
- Re-entry in the true lumen distally
- Balloon angioplasty, pre-stenting, and vessel preparation for stenting
- Careful placement of the first Supera long stent
- Overlapping and placement of the second Supera stent at the ostium level
- Evaluation of the final results
- Closing with a STARCLOSE device
Bibliography
- State of the art lecture for endovascular management of long SFA lesion - Video
- How to use DET based on clinical data review in 2016 - Video
- Feasibility and 1-Year outcomes of subintimal revascularization with Supera stenting of long femoropopliteal occlusions in critical limb ischemia - Article
- Subintimal angioplasty for lower limb arterial chronic total occlusions - Article
- Drug-eluting stents in superficial femoral artery treatment: could they be the standard of care? - Article
- A Real-World Experience With the Supera Interwoven Nitinol Stent in Femoropopliteal Arteries - Article
Shooting date : 2016-10-19
Last update : 2021-05-11
Last update : 2021-05-11
Our Cases of the Month
The case of the month is a new way for our users to watch, learn, and share with incathlab. They can watch a video that highlights an innovative case and uses excellent pedagogical techniques, lear...
Share
Join the Discussion
Suggestions
Discover your Monthly Case
Honolulu : Sunday, September 17th 2023 from 10:07pm to 10:07pm (GMT+2)
San Francisco : Monday, September 18th 2023 from 01:07am to 01:07am (GMT+2)
New York : Monday, September 18th 2023 from 04:07am to 04:07am (GMT+2)
Buenos Aires : Monday, September 18th 2023 from 05:07am to 05:07am (GMT+2)
Reykjavik : Monday, September 18th 2023 from 08:07am to 08:07am (GMT+2)
London / Dublin : Monday, September 18th 2023 from 09:07am to 09:07am (GMT+2)
Paris / Berlin : Monday, September 18th 2023 from 10:07am to 10:07am (GMT+2)
Istanbul : Monday, September 18th 2023 from 11:07am to 11:07am (GMT+2)
Moscou / Dubaï : Monday, September 18th 2023 from 12:07pm to 12:07pm (GMT+2)
Bangkok : Monday, September 18th 2023 from 03:07pm to 03:07pm (GMT+2)
Shanghai : Monday, September 18th 2023 from 04:07pm to 04:07pm (GMT+2)
Tokyo : Monday, September 18th 2023 from 05:07pm to 05:07pm (GMT+2)
Sydney : Monday, September 18th 2023 from 07:07pm to 07:07pm (GMT+2)
Wellington : Monday, September 18th 2023 from 09:07pm to 09:07pm (GMT+2)
San Francisco : Monday, September 18th 2023 from 01:07am to 01:07am (GMT+2)
New York : Monday, September 18th 2023 from 04:07am to 04:07am (GMT+2)
Buenos Aires : Monday, September 18th 2023 from 05:07am to 05:07am (GMT+2)
Reykjavik : Monday, September 18th 2023 from 08:07am to 08:07am (GMT+2)
London / Dublin : Monday, September 18th 2023 from 09:07am to 09:07am (GMT+2)
Paris / Berlin : Monday, September 18th 2023 from 10:07am to 10:07am (GMT+2)
Istanbul : Monday, September 18th 2023 from 11:07am to 11:07am (GMT+2)
Moscou / Dubaï : Monday, September 18th 2023 from 12:07pm to 12:07pm (GMT+2)
Bangkok : Monday, September 18th 2023 from 03:07pm to 03:07pm (GMT+2)
Shanghai : Monday, September 18th 2023 from 04:07pm to 04:07pm (GMT+2)
Tokyo : Monday, September 18th 2023 from 05:07pm to 05:07pm (GMT+2)
Sydney : Monday, September 18th 2023 from 07:07pm to 07:07pm (GMT+2)
Wellington : Monday, September 18th 2023 from 09:07pm to 09:07pm (GMT+2)
Complex multivascular patient with occluded brachiocephalic trunk
Case of the month: September 2023
Share
Stenting of obstructive right femoro-iliac post-thrombotic lesions
Case of the month: January 2020
Share
Complex Ostial LAD CTO: Saphenous vein Graft as an Option for Retrograde Approach
Case of the month: July 2019 - Live case #7 ML CTO
Share
Very complex Mid RCA occlusion
Retrograde in 1st intention and Antegrade approach for recanalization
Share
Live Case #6 : Percutaneous Bypass for long femoro-popliteal artery occlusion
Case of the month: April 2021
Share
Celiac trunk stenting. Brachial artery approach. STARCLOSE closing
From Louis Pasteur Clinic, Essey Les Nancy, France
Share
Mehmet E. nice work... thanks for sharing.
Segal D. Nice job!
mohamed D. Thank you Sir
I usually use not less than 6mm balloon for SFA
I usually make only 5mm stent overlap
What Do you think Sir?
Rabindranath Kowlessur J. nice case
narayana reddy B. Nice case,well done
Ralf L. As for the overlap in Standard Nitinol stents 5 mm is an appropriate overlap, but for Supera it should be longer. It is a closed cell design stent and the wires are independently moving and have the possibility to even out over time. There still can be some movement and a sepeation of the to stents should be avoided.
venkatesa reddy D. good learning
Oleksandr Z. Perfect job, thanks a lot for experience
mohamad ali A. Well done
Popeski P. .
Popeski P. .
Ante K. Very nice job!
In 15.33 of movie I see stenosis of PFA what is disappears in another projection.
Majed A. Sehr schön
Chakyarpoyil A. well done