Management of a "saddle" embolus at the popliteal bifurcation by a variation of the "push and park" approach. A case report.

ABSTRACT

We present a modification of a previously reported endovascular technique where a large embolus was "pushed and parked" into a diseased artery. A saddle embolus at the bifurcation of the popliteal artery, which occurred as a complication after a percutaneous subintimal recanalization, was pushed and parked into the tibio-peroneal trunk. This was achieved using 2 balloon catheters, one to disengage the embolus from the anterior tibial artery, and the other to push the embolus into the tibio-peroneal trunk, thus establishing flow into the anterior tibial artery. Pushing and parking an embolus into a less useful vessel when all attempts at catheter embolectomy have failed is a simple and quick method which should be borne in mind by all vascular interventionalists.