Use of a percutaneous puncture needle for true lumen re-entry during subintimal recanalization of the superficial femoral artery Amr M. Aborahma, MD

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Use of a percutaneous puncture needle for true lumen re-entry during subintimal recanalization of the superficial femoral artery Amr M. Aborahma, MD Journal of Vascular Surgery Cases and Innovative Techniques Volume 2, Issue 3, Pages 108-110 (September 2016) DOI: 10.1016/j.jvscit.2016.05.007 Copyright © 2016 The Author(s) Terms and Conditions

Fig 1 A, The red arrow points to the antegrade wire trapped in the subintimal space. The blue arrow points to the retrograde puncture needle with the wire descending from it into the popliteal artery intraluminally. B, The arrow points to the angled catheter directed to the tip of the needle with successful re-entry of the antegrade wire into the true lumen. Journal of Vascular Surgery Cases and Innovative Techniques 2016 2, 108-110DOI: (10.1016/j.jvscit.2016.05.007) Copyright © 2016 The Author(s) Terms and Conditions

Fig 2 A, Chronic total occlusion (CTO) of the middle third extending into the distal third of the superficial femoral artery (SFA), with the catheter (red arrow) in the subintimal plane approaching the re-entry point (blue arrow). B, The puncture needle (blue arrow) left in place and a trial to direct the wire with the angled catheter (red arrow) toward the tip of the needle. C, Successful sliding of the wire (red arrow) beside the needle (blue arrow) into the true lumen. Journal of Vascular Surgery Cases and Innovative Techniques 2016 2, 108-110DOI: (10.1016/j.jvscit.2016.05.007) Copyright © 2016 The Author(s) Terms and Conditions

Fig 3 A, The tip of the antegrade angled catheter (red arrow) approaching the tip of the needle (blue arrow). B, Successful sliding of the wire beside the needle (black arrow). Journal of Vascular Surgery Cases and Innovative Techniques 2016 2, 108-110DOI: (10.1016/j.jvscit.2016.05.007) Copyright © 2016 The Author(s) Terms and Conditions