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Advanced Technical IVT

subintimal angioplasty

Technique for crossing chronic total occlusions by creating a controlled dissection plane.

Full Definition

Subintimal angioplasty is a specialized endovascular technique used to treat chronic total arterial occlusions by deliberately creating a controlled dissection in the subintimal space. The procedure involves advancing a wire and balloon outside the true vessel lumen, within the vessel wall, to bypass the occluded segment and re-enter the true lumen distally. This technique is particularly useful for long-segment occlusions in peripheral arteries where conventional intraluminal crossing is not possible. Success depends on proper patient selection, appropriate re-entry techniques, and adequate distal vessel quality for re-establishment of flow.

Usage

Usage note: Emphasize the intentional nature of the subintimal dissection to distinguish from complications.

In Context

  • "Subintimal angioplasty successfully recanalized the chronically occluded superficial femoral artery." — Interventional procedure report
  • "The subintimal plane was maintained until successful re-entry into the true lumen was achieved." — Technical procedure description

Also known as

subintimal recanalization SAFARI technique

Contrasted with

intraluminal angioplasty

Don't confuse with

intentional dissection vessel perforation

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