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Purpose: We evaluated the feasibility and safety of the reverse catheterization technique of the superficial femoral artery (ReCAT) for single-stage endovascular treatment (EVT) in patients with bilateral infrainguinal diseases. Materials and Methods: We retrospectively evaluated 24 consecutive patients (overall median age: 79 years; male patients: 21 [87.5%]) who underwent EVT for bilateral infrainguinal diseases. The objective of ReCAT was to perform single-stage EVT in patients with bilateral infrainguinal diseases with a one-time unilateral femoral artery puncture. The main outcomes were the incidence of puncture site complications, including major bleeding or hematoma requiring transfusion, pseudoaneurysm, and arteriovenous fistula, and ReCAT procedure-related arterial dissection or perforation, which were assessed by ultrasonography on the day after the procedure. The secondary outcome measures were in-hospital mortality and in-hospital amputation. Results: Reverse catheterization technique of the superficial femoral artery was successful in 23 (95.8%) of the 24 patients; it failed in 1 patient due to severe calcification and a previously implanted stent in the ipsilateral iliac artery. The median operation time, radiation time, and the volume of contrast media used were 108 (84-142) minutes, 37 (27-55) minutes, and 111 (80-157) mL, respectively. There were no incidences of puncture site complications and arterial dissection related to the ReCAT procedure. One case of vessel perforation in a branch of the ipsilateral superficial femoral artery occurred due to flipped guidewire injury. Conclusion: Reverse catheterization technique of the superficial femoral artery is safe and effective in performing single-stage EVT for bilateral infrainguinal diseases. It might also reduce the number of EVTs and complications due to multiple femoral artery punctures. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the practical usefulness of dual lumen catheter-facilitated reverse wire technique.Background: We sometimes encounter difficulty in introducing a guidewire to the highly angulated side branch. In those cases, the reverse wire technique is considered as a last resort to overcome the situation.Methods: Between January 2013 and June 2015, we performed the reverse wire technique for guidewire crossing into an extremely angulated side branch in consecutive seven cases with true bifurcated lesions. We retrospectively evaluated patients' backgrounds, lesion characteristics, and details of the percutaneous coronary intervention (PCI) procedures.Results: Three interventional cardiologists with various levels of experience in coronary intervention performed this technique. A polymer-jacket hydrophilic-coated guidewire was used for the reverse wire system excluding in one case, and we adopted a sharp curve for the tip shape in all cases. After crossing the reverse wire into a highly angulated side branch, we usually deliver a flexible micro catheter over the guidewire for the purpose of guidewire exchange. We deployed a stent in the side branch in three cases. We successfully performed all PCI procedures without any complications and no major adverse cardiac event was observed during hospitalization.Conclusions: We could safely and effectively perform the reverse wire technique for guidewire crossing into a markedly angulated side branch. We recommend a polymer-jacket hydrophilic-coated guidewire with a sharp curve in the tip shape for this technique. All interventional cardiologists should acquire knowledge and skills regarding this guidewire manipulation technique. [ABSTRACT FROM AUTHOR]