Combination of Carbon Dioxide Angiography and Outback® Elite for Revascularization of a Patient with Renal Insufficiency with Bilateral Femoropopliteal Chronic Total Occlusions

Figure 2

Initially, we performed EVT to treat the occlusion of her left SFA. We used a new reentry device called an Outback Elite and the contralateral approach. Two orthogonal angiographic views are essential to confirm the right direction: an L-shaped fluoroscopic marker provides the orientation of the tip toward the reentry site, and fine tuning of the positioning is needed when using a T-shaped fluoroscopic marker to confirm the desired alignment. Next, a 22 G nitinol reentry cannula was plunged into the distal true lumen in the distal SFA. A 0.014-inch extrasupport wire was advanced into the true lumen. EVT: endovascular therapy; SFA: superficial femoral artery.

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