One-year outcome of retrograde vascular access in peripheral arterial disease of Asian origin.

BACKGROUND

Retrograde puncture is a safe alternative after the antegrade approach has failed, and complications at the puncture site are rare. However, the differences in the retrograde puncture side, outcomes, and complications between intermittent claudication (IC) and chronic limb ischaemia (CLI) remain unclear, particularly for Asian populations, and studies on this population are scarce.

MATERIAL AND

METHODS

A retrospective analysis was conducted on 255 consecutive patients with symptomatic peripheral arterial disease undergoing tibio-pedal or distal femoral artery retrograde puncture for endovascular intervention at our institute between January 2018 and December 2022. Preoperative, periprocedural, and postoperative complications and long-term outcomes were evaluated.

RESULTS

The success rates for puncture and cannulation were 100% and 86.4%, respectively, in the intermittent claudication group (IC) and 95.8% and 81.5%, respectively, in the chronic limb ischaemia group (CLI). Failure was primarily due to vessel calcification and small vessel calibre hindering penetration and to occluded lesions. Puncture-related complications included fistula formation, haematoma, distal embolism, vessel spasm, and foreign body trapping in the lumen and occurred in 6.8% of patients in the IC group and 8.5% of those in the CLI group. The IC group had a significantly shorter admission duration (10.0 ± 14.4 vs. 16.4 ± 16.6 days, p=0.001∗).

CONCLUSIONS

In Asian patients with peripheral arterial disease, retrograde puncture is a safe and effective alternative in IC and CLI cases in which the antegrade method fails.