Feasibility and Safety of the REVERT Technique for Single-Access Endovascular Treatment of Peripheral Artery Disease

Abstract Peripheral artery disease (PAD) is associated with increased mortality, limb loss, and disability, impacting over 230 million individuals globally. The REVERT technique, designed for single-access management of ipsilateral lower extremity PAD, may reduce complications related to multiple punctures. This study aims to evaluate the efficacy and safety of the REVERT technique in endovascular interventions. This retrospective study reviewed 12 patients treated with the REVERT technique at our institution from January 2019 to October 2022. Patient demographics (age, gender, Rutherford classification) and procedural data (sheath sizes, puncture methods, hemostasis techniques) were collected. Complications were assessed based on the Society of Interventional Radiology standards. The mean age of the cohort was 72 years, with 75% male patients, and 58.3% presented with critical ischemia (Rutherford ≥4). No acute limb ischemia cases were observed, and the REVERT technique was successfully performed in all cases without major complications. One case of sheath kinking was resolved by replacing it with a kink-resistant sheath. The REVERT technique appears to be a safe and effective method for single-stage endovascular treatment of ipsilateral or bilateral PAD, with minimal complications. Larger-scale studies are recommended to further validate these findings and optimize clinical applications.