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DOI: 10.1055/s-0045-1806865
Feasibility and Safety of the REVERT Technique for Single-Access Endovascular Treatment of Peripheral Artery Disease
Funding None.
Abstract
Objective
Peripheral artery disease (PAD) is associated with increased mortality, limb loss, and disability, impacting over 230 million individuals globally. The REVERT technique, designed for single-access management of ipsilateral lower extremity PAD, may reduce complications related to multiple punctures. This study aims to evaluate the efficacy and safety of the REVERT technique in endovascular interventions.
Methods
This retrospective study reviewed 12 patients treated with the REVERT technique at our institution from January 2019 to October 2022. Patient demographics (age, gender, Rutherford classification) and procedural data (sheath sizes, puncture methods, hemostasis techniques) were collected. Complications were assessed based on the Society of Interventional Radiology standards.
Results
The mean age of the cohort was 72 years, with 75% male patients, and 58.3% presented with critical ischemia (Rutherford ≥4). No acute limb ischemia cases were observed, and the REVERT technique was successfully performed in all cases without major complications. One case of sheath kinking was resolved by replacing it with a kink-resistant sheath.
Conclusion
The REVERT technique appears to be a safe and effective method for single-stage endovascular treatment of ipsilateral or bilateral PAD, with minimal complications. Larger-scale studies are recommended to further validate these findings and optimize clinical applications.
Ethical Approval
This retrospective study protocol adhered to the principles outlined in the Declaration of Helsinki and received approval from the institutional review board under reference number 2022000604–1.
Informed Consent
Individual informed consent was routinely obtained from all patients for their procedures, but additional consent specific to the study was not required due to the retrospective nature of the research.
Availability of Data and Materials
The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Publication History
Article published online:
26 March 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 Ray KK, Ference BA, Séverin T. et al. World Heart Federation Cholesterol Roadmap 2022. Glob Heart 2022; 17 (01) 75
- 2 Gerhard-Herman MD, Gornik HL, Barrett C. et al. 2016 AHA/ACC Guideline on the management of patients with lower extremity peripheral artery disease: executive summary—a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2017; 135 (12) e686-e725
- 3 Thukkani AK, Kinlay S. Endovascular intervention for peripheral artery disease. Circ Res 2015; 116 (09) 1599-1613
- 4 Kadoya Y, Zen K, Kato T. et al. Feasibility and safety of reverse catheterization technique of the superficial femoral artery in single-stage endovascular treatment of bilateral infrainguinal diseases. Vasc Endovascular Surg 2019; 53 (03) 206-211
- 5 Rajebi H, Rajebi MR. Optimizing common femoral artery access. Tech Vasc Interv Radiol 2015; 18 (02) 76-81
- 6 Irani F, Kumar S, Colyer Jr WR. Common femoral artery access techniques: a review. J Cardiovasc Med (Hagerstown) 2009; 10 (07) 517-522
- 7 Kinnaird TD, Stabile E, Mintz GS. et al. Incidence, predictors, and prognostic implications of bleeding and blood transfusion following percutaneous coronary interventions. Am J Cardiol 2003; 92 (08) 930-935
- 8 Khalilzadeh O, Baerlocher MO, Shyn PB. et al. Proposal of a new adverse event classification by the Society of Interventional Radiology Standards of Practice Committee. J Vasc Interv Radiol 2017; 28 (10) 1432-1437.e3
- 9 Hartnell G. An improved reversal technique from retrograde to antegrade femoral artery cannulation. Cardiovasc Intervent Radiol 1998; 21 (06) 512-513
- 10 Miralles M, Candela E, Blanes E, Ribé L. Reverse retrograde approach: an alternative method for ipsilateral access to the superficial femoral artery. EJVES Short Rep 2016; 30: 7-9