Article ; Online: Recanalization of Chronic Femoropopliteal Total Occlusions after Failed Anterograde Attempt: Use of an Intravascular Ultrasound-Guided Re-entry Catheter versus the Bidirectional Approach.
Journal of vascular and interventional radiology : JVIR
2023 Volume 35, Issue 3, Page(s) 377–383
Abstract: Purpose: To analyze the feasibility and effectiveness of the use of an intravascular ultrasound (IVUS)-guided re-entry catheter (IGRC) for femoropopliteal chronic total occlusions (FP-CTOs) after a failed anterograde approach compared with the ... ...
Abstract | Purpose: To analyze the feasibility and effectiveness of the use of an intravascular ultrasound (IVUS)-guided re-entry catheter (IGRC) for femoropopliteal chronic total occlusions (FP-CTOs) after a failed anterograde approach compared with the bidirectional approach without the IGRC. Materials and methods: Between June 2019 and December 2022, an IGRC (Pioneer Plus; Philips Volcano, San Diego, California) was used in 52 patients after failure of conventional recanalization techniques (Group A). In the same period, 48 patients who were also eligible for IGRC use were treated without IGRC using the bidirectional approach (Group B). In Groups A and B, 12 (23.1%) and 3 (6.2%) patients experienced claudication, and 40 (76.9%) and 45 (93.7%) patients experienced critical limb-threatening ischemia, respectively. Clinical and procedural records, angiographic imaging findings, and follow-up data were collected, analyzed, and reviewed. Results: Technical success was achieved in 49 (94.2%) patients in Group A and 44 (91.7%) patients in Group B (P = .616). Use of the IGRC was associated with a reduction of procedural time (120 vs 133 minutes; P < .001), radiation exposure (47 vs 59 Gy cm Conclusions: Use of the IGRC was equivalently successful for FP-CTO recanalization compared with the use of the bidirectional approach, but it reduced radiation exposure, iodinated contrast medium used, patient discomfort, and procedural time. These advantages suggest that IGRC could be favored as the next-choice option for FP-CTOs after failure of anterograde recanalization. |
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MeSH term(s) | Humans ; Femoral Artery/diagnostic imaging ; Treatment Outcome ; Intermittent Claudication ; Vascular Access Devices ; Ultrasonography, Interventional/adverse effects ; Chronic Disease ; Retrospective Studies |
Language | English |
Publishing date | 2023-11-24 |
Publishing country | United States |
Document type | Journal Article |
ZDB-ID | 1137756-2 |
ISSN | 1535-7732 ; 1051-0443 |
ISSN (online) | 1535-7732 |
ISSN | 1051-0443 |
DOI | 10.1016/j.jvir.2023.11.011 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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