Journal: Journal of Vascular Surgery Cases, Innovations and Techniques

Article Title: Sequential dual rotational atherectomy for salvage of a 20-year axillobifemoral PTFE graft

doi: 10.1016/j.jvscit.2026.102238

Figure Lengend Snippet: (A-D) Stage 1 preintervention assessment and Phoenix atherectomy of the right axillobifemoral PTFE graft. (A) Color Doppler ultrasound demonstrating complete graft occlusion at the right distal axillobifemoral anastomosis with absent intragraft flow ( white curved arrow ). (B) Axial computed tomography angiography showing heavy calcification within the distal axillofemoral graft segment ( white dotted arrow ) and organized intragraft thrombus in the femorofemoral crossover, with no contrast opacification ( white straight arrow ). (C) Intraoperative angiography confirming patent right axillary and subclavian arteries with adequate contrast opacification; the ( black hollow arrow ) indicates the Phoenix 2.2-mm atherectomy catheter within the graft lumen during retrograde ascending lesion crossing and debulking, six passes. (D) Drug-coated balloon (Freeway 7 × 230 mm) angioplasty at the right distal axillobifemoral anastomosis, introduced through the initial right superficial femoral artery percutaneous access; the balloon spans the distal graft-to-right common femoral artery junction ( black arrowhead ), providing simultaneous paclitaxel delivery to the graft anastomosis and proximal native arterial segment.

Article Snippet: Jetstream XC (Boston Scientific) 2.4-mm atherectomy catheter with active aspiration performed six sequential passes, removing thrombus and debris from the femorofemoral crossover graft (approximately 15 cm anastomosis to anastomosis).

Techniques: Computed Tomography

Journal: Journal of Vascular Surgery Cases, Innovations and Techniques

Article Title: Sequential dual rotational atherectomy for salvage of a 20-year axillobifemoral PTFE graft

doi: 10.1016/j.jvscit.2026.102238

Figure Lengend Snippet: (A-C) Long-term follow-up after staged dual rotational atherectomy and drug-coated balloon angioplasty. (A) Final completion angiogram demonstrating continuous opacification of the right axillobifemoral and left femorofemoral polytetrafluorethylene (PTFE) graft segments ( black dotted line ) with Thrombolysis In Myocardial Infarction 3 antegrade flow into both lower extremities ( black arrowheads ). (B) Color Doppler ultrasound at the right distal axillobifemoral anastomosis showing restored biphasic waveform with peak systolic velocity of 53 cm/s ( white curved arrow ), confirming durable graft patency. (C) Three-dimensional computed tomography angiographic reconstruction at 18 months demonstrating complete bypass patency; red arrows indicate the right and left distal anastomoses of the axillobifemoral graft, and the blue double-headed arrow indicates symmetric bilateral lower extremity perfusion. No residual or recurrent pseudoaneurysm is identified at the right superficial femoral artery puncture site.

Article Snippet: Jetstream XC (Boston Scientific) 2.4-mm atherectomy catheter with active aspiration performed six sequential passes, removing thrombus and debris from the femorofemoral crossover graft (approximately 15 cm anastomosis to anastomosis).

Techniques: Computed Tomography