Feasibility of using the Balloon Backed-Up Microcatheter Technique to Treat Superficial Femoral Artery Occlusion Under Extra-Vascular Ultrasound Guidance Via Radial Access

Endovascular treatment (EVT) of superficial femoral artery (SFA) lesions that can be reached through transradial access (TRA) has often been performed due to its low invasiveness. For complex lesions such as chronic total occlusion (CTO) treated via TRA, EVT is still challenging due to poor device backup and guidewire operability. However, TRA might be preferred in patients with a high risk of bleeding or restricted access sites.Both patients were diagnosed with peripheral artery disease and had an occlusion in one of their SFAs. They were treated using the balloon backed-up microcatheter technique (BBQ), a novel technique devised by us to treat patients with CTO through TRA. No complications were observed in either patient; therefore, we consider that both the procedures using this technique were successful.We devised a technique that improved the backup of devices and maintained the torque response of the guidewire. This is because the 0.035-inch balloon catheter was anchored in the blood vessel and the microcatheter was trapped inside the monorail lumen of a 0.035-inch balloon catheter without crushing the lumen of the microcatheter. We introduce this technique in our report.