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Purpose: To describe a novel technique designed to safely and precisely deploy the Supera stent accurately at the ostium of the proximal superficial femoral artery (SFA) without compromising the profunda and common femoral arteries., Technique: After antegrade crossing of the chronic total occlusion (CTO) at the SFA ostium and accurate predilation of the entire SFA lesion, a retrograde arterial access is obtained. The Supera stent is navigated in retrograde fashion to position the first crown to be released just at the SFA ostium. Antegrade dilation is performed across the retrograde access site to obtain adequate hemostasis. The technique has been applied successfully in 21 patients (mean age 78.1±8.2 years; 13 men) with critical limb ischemia using retrograde Supera stenting from the proximal anterior tibial artery (n=6), the posterior tibial artery (n=2), retrograde stent puncture in the mid to distal SFA (n=2), the native distal SFA/proximal popliteal segment (n=6), and the distal anterior tibial artery (n=5). No complications were observed., Conclusion: Distal retrograde Supera stent passage and reverse deployment allow precise and safe Supera stenting at the SFA ostium.

Propylene oxide (PO), propylene glycol (PG), and polyols are produced from propylene via propylene chlorohydrin. Effluents from these plants contain biological oxygen demand/chemical oxygen demand (BOD/COD) loads besides high chloride concentrations. The high salinity poses severe problem to adopt conventional methods like activated sludge processes. Presently, a simple, economically viable and versatile microbiological process has been developed to get more than 90% biodegradation in terms of BOD/COD, utilizing specially developed Pseudomonas and Aerobacter. The process can tolerate high salinity up to 10 wt% NaCl or 5 wt% CaCl2 and can withstand wide variations in pH (5.5-11.0) and temperature (15-45 degrees C). The biodegradation of glycols involves two steps. The enzymatic conversion of glycols to carboxylic and hydroxycarboxylic acids is aided by Pseudomonas. Further degradation to CO2 and H2O by carboxylic acid utilizing Aerobacter, and possible metabolic degradative pathway of glycols are discussed. Various process parameters obtained in the lab scale (50 L bioreactor) and pilot scale (20 m3 bioreactor), and unique features of our process are also discussed.