Figure 1.

Treatment of a superficial femoral artery (SFA) occlusion from a popliteal artery approach. A 66-year-old male presents with severe right leg claudication. The patient has failed several attempts from a contralateral approach due to a postsurgical changes that involve the aortic bifurcation and the right common femoral artery. The right lower-extremity angiogram demonstrates a right distal SFA occlusion with extensive collaterals (A). Patient is treated with a right popliteal artery approach. The puncture is performed with a 21-gauge needle and ultrasound guidance supplementing fluoroscopic imaging (B). The SFA occlusion was recanalized with a wire and catheter system. The occlusion was treated with the placement of a self-expanding stent (C). Final subtraction angiogram demonstrates patency of stent (D).