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Retrograde Technique Case Study

Chameleon™ PTA balloon catheter

View how physicians use an integrated injection modality to perform combined angioplasty and targeted diagnostic imaging in retrograde fashion.

Addressing the complexities of angiogplasty in retrograde

Imaging against vascular flow

For stenoses close to a fistula’s anastomosis, retrograde access from the venous side is required — performing “against the flow,” and often resulting in diluted imagery or multiple procedural steps and catheter exchanges.

By offering PTA with an integrated contrast injection option, the Chameleon™ PTA balloon catheter enables targeted diagnostic imaging immediately following angioplasty – with the ability for repeated angioplasty and imaging directly at the lesion site as needed.

Explore the technique

Case review

Angela Kokkosis, M.D., FACS

High pressure PTA with moderate compliance in retrograde approach

  • 57-year-old male
  • End stage renal disease
  • Multiple failed accesses to left arm
  • Functioning right brachio-basilic fistula

Retrograde technique case study:
Contrast delivery in retrograde approach

No catheter exchanges needed to complete case
  • 80-year-old male
  • AV fistula with anastomotic stenosis
  • Poor flow in a brachiocephalic fistula
  • Chameleon™ PTA balloon catheter 5 x 40 mm

Tight stenosis near anastomosis

Balloon inflation at AV anastomosis

Post-inflation, deflate and advance balloon over the wire beyond anastomosis

Maintaining wire position, inject contrast through Chameleon™ PTA balloon catheter to visualize area post treatment

Step-by-step retrograde case review with Dr. Ari Kramer

Immediate before and after imaging with one device.
  • Juxta-anastomotic fistula stenosis
  • Narrowing at brachial artery and cephalic vein
  • Retrograde approach to standard AV fistula
  • Imaging of circuit while maintaining guidewire control in retrograde approach

Step 1

Once access is achieved, the Chameleon™ PTA balloon catheter is advanced to the treatment site and angioplasty is performed.

Step 2

The device is deflated and advanced to the arterial side.

Step 3

Finally, contrast is injected directly through the Chameleon™ PTA balloon catheter, enabling the assessment of angioplasty results.

Explore more clinical cases

Diversified angioplasty technique utilization

View angioplasty case studies to see the Chameleon™ PTA balloon catheter utilized in a variety of cases.

Procedural comparison study

Review a PTA balloon catheter comparison study from the Journal of Vascular Access.

Novel thrombectomy technique study

Learn about a novel thrombectomy technique using the Chameleon™ PTA balloon catheter to perform imaging, thrombectomy, and angioplasty.

Explore PTA balloon catheter options

Learn more about the unique features of the Chameleon™ PTA balloon catheter.


Tools and guidelines resources to help your staff optimize the process for procedural reimbursement.

Contact us

Connect with a Chameleon™ PTA balloon catheter representative and request details on retrograde approach methods.