Use of Collateral Branches in the Treatment of Tibial Arteries Chronic Total Occlusions (CTOs)

2013 ◽  
pp. 731-764
Author(s):  
Lanfroi Graziani
Keyword(s):  
Chronic Total Occlusions ◽  
Tibial Arteries

First Experience With The GoBack-Catheter For Successful Crossing of Complex Chronic Total Occlusions in Lower Limb Arteries

2021 ◽  
pp. 152660282110659
Author(s):  
Olaf Bakker ◽  
Yvonne Bausback ◽  
Tim Wittig ◽  
Daniela Branzan ◽  
Sabine Steiner ◽  
...  
Keyword(s):  
Lower Limb ◽  
De Novo ◽  
Target Lesion ◽  
Lesion Length ◽  
Minor Bleeding ◽  
Technical Success ◽  
Entry Site ◽  
Chronic Total Occlusions ◽  
Technical Success Rate ◽  
Tibial Arteries

Purpose: To evaluate the use of the GoBack-catheter (Upstream Peripheral Technologies) in complex revascularizations in lower limb arteries. Materials and Methods: In this retrospective single-center study, the results of the first 100 consecutive patients including 101 limb-revascularizations, performed between May 2018 and July 2020 with the study device, were analyzed. In all cases, guidewire-crossing failed, and all lesions were chronic total occlusions (CTO), either de novo, reocclusions, or in-stent reocclusions. Successful crossing was defined as passing the CTO using the study device. Patency at discharge and after 30 days was defined as less than 50% restenosis on duplex sonography, without target lesion revascularization. Results: Median lesion length was 24 cm and 38 patients (37.6%) had a calcium grading according to the peripheral arterial calcium scoring system (PACSS) of 4 or 5. In 20.8% of patients, an occluded stent was treated. CTOs involved the femoropopliteal segment in 91.1%, iliac arteries in 5.9%, and tibial arteries in 7.9%. The GoBack-catheter was employed for entering into or crossing through parts or the full length of a CTO or an occluded stent as well as for re-entering into the true lumen after subintimal crossing. The device was used via contralateral and ipsilateral antegrade as well as retrograde access with an overall technical success rate of 92.1%. In 3 patients minor bleeding occurred at the crossing or re-entry site, which were managed conservatively. Thirty-day adverse limb events comprised minor amputations in 4 patients (4.0%), 1 major amputation (1.0%), and reocclusions in 7 limbs (6.9%). Conclusion: The new GoBack-catheter offers versatile endovascular applicability for complex CTO recanalization in a broad range of peripheral vascular interventions with a high technical success and low complication rate.

Usefulness and Safety of Percutaneous Coronary Intervention for Chronic Total Occlusions in Super-Elderly Patients

2017 ◽  
Vol 9 (1) ◽  
pp. 32-36
Author(s):  
Tohru Takahashi ◽  
Takashi Nakata ◽  
Takahide Kadosaka ◽  
Tasuku Watanabe ◽  
Yosuke Terui ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Elderly Patients ◽  
Coronary Intervention ◽  
Chronic Total Occlusions ◽  
Percutaneous Coronary

Chronic Total Occlusions – The Challenge Continues

2006 ◽  
Vol 0 (2) ◽  
pp. 1
Author(s):  
Shahid Aziz ◽  
David R Ramsdale ◽  
◽  
Keyword(s):  
Chronic Total Occlusions

Real-life Bifurcation – Challenges and Potential Complications

2011 ◽  
Vol 7 (4) ◽  
pp. 283
Author(s):  
Inga Narbute ◽  
Sanda Jegere ◽  
Indulis Kumsars ◽  
Dace Juhnevica ◽  
Agnese Knipse ◽  
...  
Keyword(s):  
Stent Thrombosis ◽  
Real Life ◽  
Coronary Intervention ◽  
Side Branch ◽  
The Body ◽  
Chronic Total Occlusions ◽  
Vein Grafts ◽  
Procedural Complications ◽  
Drug Eluting ◽  
Bifurcation Lesions

Together with calcified lesions, saphenous vein grafts, chronic total occlusions and unprotected left main lesions, bifurcation lesions are complex lesions that remain among the outstanding challenges of treatment with percutaneous coronary intervention. Bifurcation lesions are associated with increased rates of procedural complications, restenosis and adverse events than lesions in the body of the vessel. The introduction of drug-eluting stents for the treatment of bifurcation lesions has dramatically decreased restenosis rates, especially in patients suffering from diabetes. However, abrupt side branch closure, side branch ostial restenosis and stent thrombosis remain areas where further improvement is needed. Although a provisional T-stent strategy is most often used when side branch stenting is required, there are true bifurcation lesions where the selected use of more complex bifurcation approaches (such as the crush technique, T-stenting or the culotte technique) seem appropriate, particularly when the main branch and side branch are larger vessels with more diffuse side branch disease. The major challenge with any technique is to ensure that the side branch is protected and there is a satisfactory final result. Many technical questions rise in trying to ensure this outcome and lower the risk of intra- and post-procedural complications such as side branch closure and restenosis, stent thrombosis, dissection and fracture of a jailed wire: how can difficult side branch access be solved? How can unfavourable side branch anatomy be re-wired after main vessel stent placement? How can fracture of a jailed wire be avoided? Is side-strut dilation beneficial?

CLINICAL, ELECTROCARDIOGRAPHIC, AND PROCEDURAL CHARACTERISTICS OF PATIENTS WITH CORONARY CHRONIC TOTAL OCCLUSIONS

2020 ◽  
Vol 23 (14) ◽  
Author(s):  
Haider Hamza Omran ◽  
Dr Basim Mohammed Mothlum
Keyword(s):  
Chronic Total Occlusions

Infrapopliteal Arterial Pseudoaneurysm Development Secondary to Blunt Trauma: Case Series and Literature Review

2020 ◽  
Vol 54 (4) ◽  
pp. 367-374
Author(s):  
Matthew T. Chrencik ◽  
Brian Caraballo ◽  
John Yokemick ◽  
Peter J. Pappas ◽  
Brajesh K. Lal ◽  
...  
Keyword(s):  
Literature Review ◽  
Blunt Trauma ◽  
Case Series ◽  
Duplex Ultrasound ◽  
Endovascular Coiling ◽  
Skeletal Trauma ◽  
Delay In Diagnosis ◽  
Tibial Arteries ◽  
Pulsatile Mass ◽  
Orthopedic Injuries

Objectives: Infrapopliteal arterial pseudoaneurysms (IAP) following blunt trauma with associated orthopedic injuries are uncommon, often present in a delayed fashion, and encompass a diagnostic and therapeutic dilemma. Herein, we present a series of IAPs that were diagnosed following blunt trauma and their management. Methods: Case series consisting of 3 patients and a review of the international literature. Results: Our case series included 3 patients presenting with IAPs following blunt trauma with associated orthopedic injuries. They were all identified in a delayed manner (>3 weeks) after the orthopedic injuries were treated. All patients presented with pain and a pulsatile mass while one concurrently had neurologic deficits. The pseudoaneurysms were diagnosed by duplex ultrasound and confirmed by angiography to be originating from the tibioperoneal trunk, anterior tibial, and posterior tibial arteries respectively. Two patients were treated with surgical excision. Of these, one required an arterial bypass procedure while the other underwent direct ligation only. The third patient was treated by endovascular coiling. A literature review from 1950 to the present found 51 reported cases of IAP resulting from blunt trauma. Ninety percent of trauma-related infrapopliteal injuries occurred in men with a mean delay in diagnosis of 5.6 months (median 1.8 months) after injury. Since 1950, management has shifted from primarily ligation to incorporating minimally invasive endovascular techniques when appropriate. Conclusions: Infrapopliteal artery pseudoaneurysms are rare following blunt skeletal trauma. A delay in diagnosis often occurs and can result in major morbidity and extensive surgical intervention. We recommend a high index of suspicion and a thorough vascular examination in patients with lower extremity skeletal trauma to help identify and treat these injuries early and effectively.

Coronary Sinus Reducer for the Treatment of Chronic Refractory Angina: Will This Challenge the Treatment of Coronary Chronic Total Occlusions?

2021 ◽  
Vol 23 (4) ◽  
Author(s):  
Giovanni Maria Vescovo ◽  
Carlo Zivelonghi ◽  
Michele Bellamoli ◽  
Paul Vermeersch ◽  
Stefan Verheye ◽  
...  
Keyword(s):  
Coronary Sinus ◽  
Refractory Angina ◽  
Chronic Total Occlusions

scholarly journals Distal Re-Entry to Treat Lower Limb Chronic Total Occlusions Using a Novel Electrically Guided Re-Entry Catheter

2021 ◽  
Author(s):  
Dennis Lui ◽  
Sorin Popa ◽  
Robert J. Dickinson ◽  
Lorenzo Patrone
Keyword(s):  
Lower Limb ◽  
Chronic Total Occlusions
Sign in / Sign up

Export Citation Format

Share Document