Abstract:

Objective This study focused the safety and efficacy of popliteal artery access for retrograderecanalization of superficial femoral artery（SFA）chronic total occlusion（CTO）lesions. Methods The clinicaland one year follow⁃up data of patients with SFA CTO lesions underwent endovascular recanalization in The First Affiliated Hospital of Zhengzhou University from March 2012 to March 2019 were reviewed retrospectively. The antegrade recanalization of SFA CTO through conventional contralateral femoral artery access in the supine positionwas selected as FA group（2 265 patients）. The retrograde recanalization of SFA CTO through popliteal arteryaccess in the prone position was PA group（216 patients）. Results The two groups had similar outcome of technicalsuccess rate，usage rate of stent and peri⁃operative（30 days）adverse event，which included death，arterial dissec⁃tion，distal embolization，puncture complications. FA group had obviously higher rate of CTO equipment usage andmore longer procedure time and fluoroscopy time than PA group（P＜0.05）. There were no difference between twogroups in 1⁃year primary patency，amputation⁃free survival，incidence of major adverse cardiovascular event，which consisted of myocardial infarction，stroke and death from any cause. Conclusions The recanalization ofSFA CTO lesions through PA access was safe and effective comparable with conventional FA access. This techniqueshould be considered as alternative with FA access.

Key words: chronic total occlusion lesions, superficial femoral artery, femoral artery access, ante?grade recanalization, popliteal artery access, retrograde recanalization