Figure 3.

Superficial femoral artery (SFA) recanalization using a needle reentry system. A 75-year-old male presents with a nonhealing ulcer in the right foot. Digital subtraction angiogram from a contralateral left common femoral approach demonstrates a long-segment right SFA occlusion (A). Attempts of recanalization of SFA using a catheter and wire system (B) results in subintimal course along the distal SFA (C). A needle-based reentry system, Outback catheter (Cordis, Bridgewater, NJ), is positioned and deployed toward the calcified but patent luminal vessel (D). The true lumen can be targeted using different fluoroscopic projections. The needle system is utilized until the 0.014-inch wire is advanced in an intraluminal location. (E). Final subtraction angiogram after dilatation and self-expanding stent placement in the SFA (F).