Retrograde pedal access and percutaneous mechanical thrombectomy for salvage of an occluded vein bypass

Managing occlusions in a lower extremity bypass is challenging, but there are several surgical methods and percutaneous devices for treatment. A 64-year-old male presented with subacute failure of his infrainguinal vein bypass. Because we were unable to access the bypass in an antegrade fashion, we accessed the bypass graft via retrograde pedal access. The occluded vein graft was salvaged with the PounceTM percutaneous mechanical thrombectomy system with the use of 014 through and through buddy wire to maintain access in the bypass alongside the PounceTM system to allow multiple passes of the nitinol baskets to retrieve thrombus.