ABSTRACT
Objective To evaluate the feasibility and safety of using bidirectional subintimal technique,i.e.subintimal arterial flossing with antegrade-retrograde intervention (SAFARI),in endovascular treatment of subclavian arterial occlusion when the guide wire cannot re-enter into the distal true cavity.Methods The clinical data of 11 patients with symptomatic subclavian artery occlusion,who were admitted to authors' hospital during the period from August 2013 to June 2016 to receive treatment,were retrospectively analyzed.The patients included 8 males and 3 females,with a mean age of 67 years old (61-74 years).Endovascular recanalization of subclavian artery with SAFARI technique and stent implantation were carried out in all patients after conventional reopening surgery of obstructed artery failed.Results Subclavian artery recanalization by using SAFARI technique together with implantation of stent (average length of 46.4 mm) was successfully accomplished in 10 patients,but in one patient the technical management failed,the technical success rate was 90.9％.No serious postoperative complications occurred.The patients were followed up for 6-36 months by telephone,and no in-stent restenosis was verified during the follow-up period.Conclusion In treating severely calcified and long-segmental subclavian artery occlusion,endovascular treatment using SAFARI technique is safe and effective,SAFARI technique can further improve the success rate of endovascular treatment.