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Fig. 1 | CVIR Endovascular

Fig. 1

From: Targeted tibio-peroneal re-entry during subintimal revascularization using the Outback® catheter

Fig. 1

a, b and c: initial runoff prior to revascularization showing a chronic occlusion of the popliteal artery and besides collateral vessels a single vessel runoff via the considerably atherosclerotic peroneal artery; the tibio-peroneal trunc is in part preserved and ideal for a targeted re-entry in case of subintimal recanalization d: failed subintimal recanalization with the 0.014″ CTO wire within the subintimal space parallel to the true lumen but with a considerable large distance; a spontaneous re-entry was considered to be highly unlikely and targeted re-entry with the Outback® device chosen to complete the intervention; e: positioning of the Outback® catheter at the level of the tibio-peroneal trunc still a few millimeters too high and oriented to the wrong direction; after correct alignment the target lumen was accessed with a single needle deployment; f: balloon angioplasty of the distal popliteal artery, the tibio-peroneal trunc and the proximal peroneal artery after successful re-entry; g and h: final result after placement of a self-expandable stent (Biotronik Astron Pulsar®)

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