Femoropopliteal Artery Chronic Total Occlusion Intervention

2017 ◽  
pp. 23-40
Author(s):  
Subhash Banerjee ◽  
Emmanouil S. Brilakis
Keyword(s):  
Chronic Total Occlusion ◽  
Total Occlusion ◽  
Femoropopliteal Artery

scholarly journals Endovascular Sharp Recanalization for Calcified Femoropopliteal Artery Occlusion

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Hsuan-Li Huang ◽  
Hsin-Hua Chou ◽  
Tien-Yu Wu
Keyword(s):  
Success Rate ◽  
Chronic Total Occlusion ◽  
Artery Occlusion ◽  
Endovascular Intervention ◽  
Total Occlusion ◽  
Femoropopliteal Artery ◽  
Sharp Recanalization ◽  
New Devices

Endovascular intervention of peripheral chronic total occlusion (CTO) is technically challenging and time consuming. Various techniques and devices are used to facilitate lesion crossing and improve the success rate of the procedure. However, these new devices are quite expensive and not readily available. We report 2 cases of peripheral CTO wherein the occlusions were successfully crossed by using stiff end of Terumo glidewire. This sharp recanalization may be a useful technique for the recanalization of calcified peripheral CTOs when conventional techniques fail and new devices are not readily available, but it is accompanied by the risk of distal atheroembolism.

Abstract 13533: 1-Year Results of Paclitaxel-Coating Nitinol Stent Placement for Chronic Total Occlusion in the Femoropopliteal Artey

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Naotaka Murata ◽  
Yoshimitu Soga ◽  
Yusuke Tomoi ◽  
Seiichi Hiramori ◽  
Yohei Kobayashi ◽  
...  
Keyword(s):  
Chronic Total Occlusion ◽  
Ankle Brachial Index ◽  
Primary Patency ◽  
Lesion Length ◽  
Total Occlusion ◽  
Femoropopliteal Artery ◽  
Nitinol Stent ◽  
Kaplan Meier ◽  
Zilver Ptx

Introduction: The mid-term outcomes of paclitaxel-coating nitinol stent (Zilver PTx) placement for chronic total occlusion (CTO) in the femoropopliteal artery have not been assessed. Hypothesis: Zilver PTx placement for CTO in the femoropopliteal artey is reliable. Methods: All patients enrolled in this prospective, single center study underwent Zilver PTx placement for de novo or restenotic CTO and non-CTO in the superficial femoral and/or popliteal artery. Baseline and follow-up Rutherford classification and Ankle-brachial index (ABI) measurements were obtained. Follow-up was completed at 3, 6, 12 months. Results: There were 61 of CTO and 58 of non-CTO treated. Mean age was 74 ± 8 years and male was 82 % in overall. Patients characteristics and degree of lesion calcification was not different significantly between two groups. CTO group had a longer mean lesion length than non-CTO group (209 mm ± 93 mm vs 131 mm ± 87 mm, P < .0001). Procedural success in both treatments was over 98 %. The operative complications were 3 cases in CTO group and 2 cases in non-CTO group. The primary patency of CTO group was significantly lower than non-CTO group in Kaplan-Meier estimate curves at 12 months (75 % vs 82 %, Log-rank P < 0.05). There were no significant differences in event-free survival or freedom from target lesion revascularization in Kaplan-Meier estimate curves at 12 months (68 % vs 70 %; Log-rank P = 0.82, 63 % vs 65 %; Log-rank P = 0.47, respectively). Both groups experienced a significant improvement in Rutherford classification and ABI after treatment, and these improvements were sustained to 12-months follow-up. Based on multivariate analysis, CTO was the negative predictor for primary patency at 12 months (HR 2.37, 95 % CI 1.02 to 5.9, adjusted P < 0.05). Conclusions: CTO influences negatively the primary patency of Zilver PTx placed in the femoropopliteal artery. However, Improvement of Rutherford classification and ABI at 12-months after CTO- intervention is sustained.

Primary Stenting for Chronic Total Occlusion of the Infrarenal Aorta

2000 ◽  
Vol 7 (4) ◽  
pp. 340-344 ◽  
Author(s):  
Christos D. Karkos ◽  
Stephen P. D'Souza ◽  
Robert Hughes
Keyword(s):  
Chronic Total Occlusion ◽  
Infrarenal Aorta ◽  
Total Occlusion ◽  
Primary Stenting

scholarly journals Successful case of direct puncture of a prosthetic bypass graft in endovascular treatment for long superficial artery chronic total occlusion: a case report

2020 ◽  
Author(s):  
Makoto Sugihara ◽  
Yoko Ueda ◽  
Yuiko Yano ◽  
Shin-Ichiro Miura
Keyword(s):  
Femoral Artery ◽  
Chronic Total Occlusion ◽  
Bypass Graft ◽  
Common Femoral Artery ◽  
Critical Limb Ischaemia ◽  
Complete Revascularization ◽  
Anastomotic Site ◽  
Graft Occlusion ◽  
Total Occlusion ◽  
Direct Puncture

Abstract Background The access site for endovascular therapy (EVT) is often limited because of multi-vascular diseases. Prior lower limb bypass can potentially limit the availability of common femoral artery access when EVT is required. Case summary An 88-year-old woman who presented with non-healing ulceration in the dorsalis pedis of the left foot despite treatment for several months was admitted to our hospital. She had undergone axillo-bilateral femoral bypass surgery for right critical limb ischaemia 3 years previously. Ultrasound and contrast computed tomography demonstrated bypass graft occlusion, left superficial femoral artery (SFA)-popliteal artery long chronic total occlusion from the origin with severe calcification and severe stenosis in the bilateral common femoral artery close to the anastomotic site. EVT for the left SFA occlusion was necessary to save the left foot, but access sites for EVT were limited. We decided to puncture an occluded axillo-femoral prosthetic bypass graft. It is difficult to cross the wire with only an antegrade approach. Therefore, it was necessary to use a bi-directional approach with dorsalis pedis artery puncture and the Rendez-vous technique. Finally, angiogram demonstrated improved blood flow to the wound site, and haemostasis at the puncture site could be achieved by manual compression. The ulceration healed within a month. Discussion Direct puncture of a prosthetic bypass graft and additional techniques resulted in complete revascularization. Thus, direct puncture of a bypass graft could be a useful EVT strategy for patients with complex and extremely long chronic total occlusion.

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