The ideal method for recanalization of complex peripheral lesions has not been determined, despite the use of the latest endovascular devices. We describe a novel method for a fully percutaneous anatomical bypass, named the “needle bypass” technique, for treatment of complex vascular lesions with failed previous surgical therapy. A 68-year-old male patient with chronic limb-threatening ischemia presented to our department. He previously had received surgical treatment 10 years prior that included the removal of the right distal common femoral artery and two surgical bypasses, an axillary-femoral bypass and an iliofemoral bypass, because he had repeated infections. He was referred to our center in order to have peripheral interventions. Since the previous conventional bridging/revascularization of the removed common femoral bifurcation had failed, the “needle bypass” technique was then used. With this novel technique, the tips of two percutaneous and bidirectional inserted needles were aligned (“needle rendezvous”) for the externalization of a guidewire in a through-and-through manner. Once this was achieved, an endovascular stent graft and an interwoven stent were deployed to cover and connect the lesion. This new technique is a minimally invasive anatomical bypass that directly connects artery to artery without any disturbance of the venous flow, and this technique, as the only option available, was performed successfully in our no-option patient. The “needle bypass” technique is an effective percutaneous treatment method in patients with no other surgical options.

中文翻译：

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“针头旁路”技术：经皮解剖旁路与针会合，用于没有其他手术选择的外周动脉疾病患者

尽管使用了最新的血管内装置，但尚未确定复杂外周病变再通的理想方法。我们描述了一种完全经皮解剖旁路的新方法，称为“针头旁路”技术，用于治疗先前手术治疗失败的复杂血管病变。一名 68 岁男性患者，患有慢性肢体威胁性缺血，就诊于我科。由于反复感染，他在 10 年前曾接受过手术治疗，包括切除右侧股骨远端总动脉和两次手术搭桥，即腋股动脉搭桥和髂股搭桥。他被转介到我们的中心，以便进行外围干预。由于之前移除的股骨总分叉的传统桥接/血运重建失败，然后使用了“针绕道”技术。使用这种新技术，两个经皮和双向插入针的尖端对齐（“针会合”），以便以贯穿式的方式将导丝外部化。一旦实现这一点，就会部署血管内支架移植物和交织支架来覆盖和连接病变。这种新技术是一种微创解剖旁路，直接将动脉连接到动脉，而不会干扰静脉流动，并且这种技术作为唯一可用的选择，在我们的无选择患者中成功实施。对于没有其他手术选择的患者，“针旁路”技术是一种有效的经皮治疗方法。两根经皮和双向插入的针的尖端对齐（“针会合”），以便以贯穿式的方式将导丝外部化。一旦实现这一点，就会部署血管内支架移植物和交织支架来覆盖和连接病变。这种新技术是一种微创解剖旁路，直接将动脉连接到动脉，而不会干扰静脉流动，并且这种技术作为唯一可用的选择，在我们的无选择患者中成功实施。对于没有其他手术选择的患者，“针旁路”技术是一种有效的经皮治疗方法。两根经皮和双向插入的针的尖端对齐（“针会合”），以便以贯穿式的方式将导丝外部化。一旦实现这一点，就会部署血管内支架移植物和交织支架来覆盖和连接病变。这种新技术是一种微创解剖旁路，直接将动脉连接到动脉，而不会干扰静脉流动，并且这种技术作为唯一可用的选择，在我们的无选择患者中成功实施。对于没有其他手术选择的患者，“针旁路”技术是一种有效的经皮治疗方法。部署血管内支架移植物和交织支架以覆盖和连接病变。这种新技术是一种微创解剖旁路，直接将动脉连接到动脉，而不会干扰静脉流动，并且这种技术作为唯一可用的选择，在我们的无选择患者中成功实施。对于没有其他手术选择的患者，“针旁路”技术是一种有效的经皮治疗方法。部署血管内支架移植物和交织支架以覆盖和连接病变。这种新技术是一种微创解剖旁路，直接将动脉连接到动脉，而不会干扰静脉流动，并且这种技术作为唯一可用的选择，在我们的无选择患者中成功实施。对于没有其他手术选择的患者，“针旁路”技术是一种有效的经皮治疗方法。