{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T06:19:31Z","timestamp":1772086771387,"version":"3.50.1"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T00:00:00Z","timestamp":1741910400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T00:00:00Z","timestamp":1741910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Heart Vessels"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>We introduce a technique for treating chronic limb-threatening ischemia with superficial femoral artery flush occlusion, facilitating intravascular treatment when conventional anterograde puncture is challenging. This retrospective study reviewed 37 patients who underwent vascular sheath fenestration assisted anterograde puncture to complete endovascular treatment for chronic limb-threatening ischemia from December 2022 to December 2023. All patients had superficial femoral artery flush occlusion, meeting chronic limb-threatening ischemia diagnostic criteria. Evaluations included intraoperative radiation dose, technical success rate, patency rate, limb retention rate, and postoperative complications from surgery to a 12-month follow-up. The mean age of the patients was 70\u2009\u00b1\u200910\u00a0years, with an age range of 46 to 90\u00a0years. A significant proportion of the cases presented with severe chronic limb-threatening ischemia, with 78.4% classified as Rutherford\u2009\u2265\u20095, 51.3% as WiFi\u2009\u2265\u20093, and 97.3% as Global Limb Anatomic Staging System III. In all surgical procedures, a plain old balloon angioplasty was utilized for anterograde dilation. Subsequently, based on angiographic findings, treatment involved either drug-coated balloon dilation combined with stent implantation or drug-coated balloon dilation alone. Successful revascularization was achieved in all cases, resulting in marked clinical and hemodynamic improvements, as evidenced by the mean ankle-brachial index increasing from 0.49 preoperatively to 0.86 postoperatively. The 12-month follow-up outcomes were as follows: limb salvage rate of 94.6%, primary patency rate of 83.8%, assisted primary patency rate of 91.9%, and secondary patency rate of 94.6%. The incidence of postoperative complications was 8.1%. The average duration of hospital stay was 8.43\u2009\u00b1\u20092.72\u00a0days. The vascular sheath fenestration assisted anterograde puncture technique demonstrates favorable surgical outcomes and merits consideration as a viable treatment option for chronic limb-threatening ischemia patients with superficial femoral artery occlusion.<\/jats:p>","DOI":"10.1007\/s00380-025-02534-6","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T06:40:19Z","timestamp":1741934419000},"page":"875-882","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A new technique of anterograde puncture for chronic limb-threatening ischemia with superficial femoral artery flush occlusion: vascular sheath fenestration"],"prefix":"10.1007","volume":"40","author":[{"given":"Zhaopeng","family":"He","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boyu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haoyong","family":"Meng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qingfu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,3,14]]},"reference":[{"issue":"2","key":"2534_CR1","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1016\/j.jvs.2023.04.006","volume":"78","author":"K Morisaki","year":"2023","unstructured":"Morisaki K, Matsuda D, Guntani A, Matsubara Y, Kinoshita G, Kawanami S, Yamashita S, Honma K, Furuyama T, Yamaoka T, Mii S, Komori K, Yoshizumi T (2023) Treatment outcomes between bypass surgery and endovascular therapy in patients with chronic limb-threatening ischemia classified as bypass-preferred category based on Global Vascular Guidelines. J Vasc Surg 78(2):475-482.e1","journal-title":"J Vasc Surg"},{"issue":"5","key":"2534_CR2","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.1016\/j.jvs.2024.05.049","volume":"80","author":"KA Giles","year":"2024","unstructured":"Giles KA, Farber A, Menard MT, Conte MS, Nolan BW, Siracuse JJ, Strong MB, Doros G, Venermo M, Azene E, Rosenfield K, Powell RJ (2024) Surgery or endovascular therapy for patients with chronic limb-threatening ischemia requiring infrapopliteal interventions. J Vasc Surg 80(5):1515\u20131524","journal-title":"J Vasc Surg"},{"issue":"1","key":"2534_CR3","doi-asserted-by":"publisher","first-page":"52","DOI":"10.23736\/S0392-9590.17.03840-8","volume":"37","author":"G Liu","year":"2018","unstructured":"Liu G, Cui C, Yin M, Ye K, Liu X, Qin J, Shi H, Huang X, Lu M, Lu X, Li W, Jiang M (2018) Staged endovascular repair of critical limb ischemia in high risk patients: the procedural and clinical outcomes. Int Angiol 37(1):52\u201358","journal-title":"Int Angiol"},{"issue":"1S","key":"2534_CR4","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/j.ejvs.2019.05.006","volume":"58","author":"MS Conte","year":"2019","unstructured":"Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH, Aboyans V, Aksoy M, Alexandrescu VA, Armstrong D, Azuma N, Belch J, Bergoeing M, Bjorck M, Chakf\u00e9 N, Cheng S, Dawson J, Debus ES, Dueck A, Duval S, Eckstein HH, Ferraresi R, Gambhir R, Gargiulo M, Geraghty P, Goode S, Gray B, Guo W, Gupta PC, Hinchlife R, Jetty P, Komori K, Lavery L, Liang W, Lookstein R, Menard M, Misra S, Miyata T, Moneta G, Munoa Prado JA, Munoz A, Paolini JE, Patel M, Pomposelli F, Powell R, Robless P, Rogers L, Schanzer A, Schneider P, Taylor S, De Ceniga MV, Veller M, Vermassen F, Wang J, Wang S, GVG Writing Group for the Joint Guidelines of the Society for Vascular Surgery (SVS), European Society for Vascular Surgery (ESVS), World Federation of Vascular Societies (WFVS) (2019) Global vascular guidelines on the management of chronic limb-threatening ischemia. Eur J Vasc Endovasc Surg 58(1S):S1\u2013S109.e33","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"1","key":"2534_CR5","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.carrev.2011.10.003","volume":"13","author":"F Airoldi","year":"2012","unstructured":"Airoldi F, Faglia E, Losa S, Tavano D, Latib A, Lanza G, Clerici G (2012) Antegrade approach for percutaneous interventions of ostial superficial femoral artery: outcomes from a prospective series of diabetic patients presenting with critical limb ischemia. Cardiovasc Revasc Med 13(1):20\u201324","journal-title":"Cardiovasc Revasc Med"},{"issue":"1","key":"2534_CR6","first-page":"1","volume":"40","author":"YW Wu","year":"2024","unstructured":"Wu YW, Wang CY, Cheng NC, Lin HJ, Huang HL, Huang JH, Chen CC, Lee JK, Chen PL, Hsu PC, Wu IH, Yeh JT, Tsai HY, Tzeng YS, Cheng CC, Lin CH, Wu SH, Tan JWH, Wu CH, Hsueh SK, Chang CH, Wu HP, Hsu CH, Yen HT, Lin PC, Lin CH, Tai HC, Chen WJ (2024) 2024 TSOC\/TSPS joint consensus: strategies for advanced vascular wound management in arterial and venous diseases. Acta Cardiol Sin 40(1):1\u201344","journal-title":"Acta Cardiol Sin"},{"issue":"2","key":"2534_CR7","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1007\/s00270-014-1039-2","volume":"38","author":"U Pua","year":"2015","unstructured":"Pua U (2015) Profunda anchor technique for ipsilateral antegrade approach in endovascular treatment of superficial femoral artery ostial occlusion. Cardiovasc Intervent Radiol 38(2):453\u2013456","journal-title":"Cardiovasc Intervent Radiol"},{"issue":"6","key":"2534_CR8","first-page":"259","volume":"28","author":"JA Mustapha","year":"2016","unstructured":"Mustapha JA, Diaz-Sandoval LJ, Jaff MR, Adams G, Beasley R, Finton S, McGoff T, Miller LE, Ansari M, Saab F (2016) Ultrasound-guided arterial access: outcomes among patients with peripheral artery disease and critical limb ischemia undergoing peripheral interventions. J Invasive Cardiol 28(6):259\u2013264","journal-title":"J Invasive Cardiol"}],"container-title":["Heart and Vessels"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00380-025-02534-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00380-025-02534-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00380-025-02534-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T17:47:17Z","timestamp":1758822437000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00380-025-02534-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,14]]},"references-count":8,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["2534"],"URL":"https:\/\/doi.org\/10.1007\/s00380-025-02534-6","relation":{},"ISSN":["0910-8327","1615-2573"],"issn-type":[{"value":"0910-8327","type":"print"},{"value":"1615-2573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,14]]},"assertion":[{"value":"20 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 February 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 March 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The author(s) declared no potential conflicts of interest with respect to the research, authorship, and\/or publication of this article. Ethical approval: This retrospective study followed the principles of the Declaration of Helsinki and was approved by the Ethics Committee of the First Hospital of Hebei Medical University. All patients agreed to have their anonymized clinical data used for research purposes.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}