{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T17:32:28Z","timestamp":1786642348364,"version":"build-2736575974"},"reference-count":5,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"abstract":"<jats:p>Despite significant progress in revascularization techniques, the vascular approach itself can still be a challenge in complex polyvascular disease. In this case report, we describe the feasibility of a potentially underutilized alternative vascular approach in a patient with multiple arterial occlusions who presented to our hospital with acute multivessel thromboses and chronic occlusions of the distal aorta and subclavian arteries, which rendered noninvasive blood pressure measurements unreliable. The patient also exhibited signs of heart failure with a severely reduced ejection fraction, likely due to ongoing ischemia, as the ventricles had not yet remodeled. To overcome the anatomical limitations safely, we used superficial temporal artery access for coronary angiography \u2013 an approach first described, to the best of our knowledge, by Csavajda et al. In addition, this access enabled angiography of the aorta and its branches, visualization of collateral flow, and invasive intra-aortic blood pressure measurement. Together with the possibility to better titrate medical therapy, this additional diagnostic information allowed us to plan aortocoronary bypass surgery with appropriate graft selection and ultimately contributed to improved patient outcomes.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Clinical Impact:<\/jats:title>\n                    <jats:p>In complex polyvascular patients with multiple arterial occlusions, when standard femoral and radial access sites are not feasible and peripheral blood pressure measurements are unreliable, an alternative vascular approach through the superficial temporal artery for coronary angiography, aortography, and invasive blood pressure measurement can be safely utilized to improve diagnostic accuracy, therapeutic planning, and clinical outcomes. This illustrative case highlights the usefulness and safety of this vascular approach and demonstrates additional technical possibilities that can be achieved through its use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15266028261477029","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T07:37:37Z","timestamp":1786433857000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Superficial Temporal Artery Access for Angiography in a Patient With Leriche Syndrome, Subclavian Artery Occlusions, Multiple Acute Arterial Thromboses, and Heart Failure"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4689-1673","authenticated-orcid":false,"given":"Tomislav","family":"Kr\u010dmar","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Diseases, University Hospital Centre Zagreb, Croatia"},{"name":"Faculty of Medicine, University of Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2587-1932","authenticated-orcid":false,"given":"Petra","family":"Grubi\u0107 Rotkvi\u0107","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, University Hospital Centre Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6871-8746","authenticated-orcid":false,"given":"Tomislav","family":"Toki\u0107","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Centre Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zvonimir Ante","family":"Korda","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Centre Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1340-1917","authenticated-orcid":false,"given":"Majda","family":"Vrki\u0107 Kirhmajer","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, University Hospital Centre Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mislav","family":"Puljevi\u0107","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, University Hospital Centre Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2492-3702","authenticated-orcid":false,"given":"Hrvoje","family":"Ga\u0161parovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Centre Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1482-6503","authenticated-orcid":false,"given":"Jo\u0161ko","family":"Bulum","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, University Hospital Centre Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"issue":"2","key":"e_1_3_2_2_2","article-title":"Superficial temporal artery access for percutaneous coronary artery stenting during the COVID-19 pandemic: a case report","volume":"5","author":"Csavajda \u00c1","year":"2020","unstructured":"Csavajda \u00c1, Bertrand OF, Merkely B, Ruzsa Z. Superficial temporal artery access for percutaneous coronary artery stenting during the COVID-19 pandemic: a case report. Eur Heart J Case Rep. 2020;5(2):ytaa520.","journal-title":"Eur Heart J Case Rep"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1182\/hematology.2021000235"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht565"},{"issue":"2","key":"e_1_3_2_5_2","first-page":"195","article-title":"A further word of caution before using the internal mammary artery for coronary revascularization in patients with severe peripheral vascular disease!","volume":"75","author":"Ben-Dor I","year":"2010","unstructured":"Ben-Dor I, Waksman R, Satler LF, et al. A further word of caution before using the internal mammary artery for coronary revascularization in patients with severe peripheral vascular disease! Catheter Cardiovasc Interv. 2010;75(2):195-201.","journal-title":"Catheter Cardiovasc Interv"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1067\/mva.1990.25254"}],"container-title":["Journal of Endovascular Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15266028261477029","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15266028261477029","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15266028261477029","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T16:49:08Z","timestamp":1786639748000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15266028261477029"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,11]]},"references-count":5,"alternative-id":["10.1177\/15266028261477029"],"URL":"https:\/\/doi.org\/10.1177\/15266028261477029","relation":{},"ISSN":["1526-6028","1545-1550"],"issn-type":[{"value":"1526-6028","type":"print"},{"value":"1545-1550","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,11]]},"article-number":"15266028261477029"}}