Transradial intervention for chronic total occlusion at the external iliac artery using a bidirectional approach through a single guiding catheter

2016 ◽  
Vol 32 (2) ◽  
pp. 174-177 ◽  
Author(s):  
Norihiko Shinozaki ◽  
Takashi Minowa ◽  
Yuji Ikari
Keyword(s):  
Iliac Artery ◽  
Chronic Total Occlusion ◽  
External Iliac Artery ◽  
Total Occlusion ◽  
Transradial Intervention ◽  
Guiding Catheter

scholarly journals Treatment of an external iliac artery chronic total occlusion using alternate access sites

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Justin Ratcliffe ◽  
Mike Gorenchtein ◽  
Pankaj Khullar ◽  
Abel Casso Dominguez ◽  
Mohan Satish ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Chronic Total Occlusion ◽  
External Iliac Artery ◽  
Arterial Disease ◽  
Patient Comfort ◽  
Vascular Lesions ◽  
Symptom Improvement ◽  
Total Occlusion ◽  
Maximal Medical Therapy ◽  
Peripheral Arterial

Abstract Background With the advent of endovascular techniques, alternate sites such as the pedal and radial arteries can now be accessed when treating peripheral arterial disease to reduce procedural complications, shorten recovery time, and improve patient comfort. However, a paucity of literature exists on the availability of support devices that can be utilized during challenging cases. Case presentation A 70 year-old female patient presented for evaluation of severe lifestyle-limiting left-sided claudication refractory to maximal medical therapy. Angiography revealed a chronic total occlusion of the left external iliac artery, which was treated successfully by percutaneous intervention via a primary transpedal approach and with the assistance of the Outback® Elite re-entry device. The patient was discharged 2 h after the procedure and reported significant symptom improvement at follow-up. Conclusion This case highlights a newly adopted endovascular approach through an alternate access site and illustrates how the Outback® Elite device can be used as an adjunctive tool in the treatment of complex lower-extremity vascular lesions.

scholarly journals Efficacy of three-dimensional roadmapping by fusion of computed tomography angiography with volumetric data from an angiography machine in endovascular therapy for iliac chronic total occlusion: a case report

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Naoki Hayakawa ◽  
Satoshi Kodera ◽  
Noriyoshi Ohki ◽  
Junji Kanda
Keyword(s):  
Computed Tomography ◽  
Endovascular Therapy ◽  
Iliac Artery ◽  
Chronic Total Occlusion ◽  
Three Dimensional ◽  
External Iliac Artery ◽  
Common Femoral Artery ◽  
Volumetric Data ◽  
Total Occlusion ◽  
Enhanced Computed Tomography

Abstract Background The usefulness of endovascular therapy (EVT) for the iliac artery has been established. However, difficult cases such as a long total occlusion and tortuous vessels are sometimes encountered. We recently performed rotational angiography with an angiography machine immediately before EVT and fused three-dimensional (3D) anatomical information obtained from preoperative enhanced computed tomography (CT) that had been performed in advance to create a 3D roadmap. We termed this method the CT fusion 3D roadmap (CTf3D-RM) technique and used it for treatment of iliac occlusive disease. Case presentation A 73-year-old man presented with pain in his left leg while resting. CT showed total occlusion from the ostium of the common iliac artery (CIA) to the distal part of the external iliac artery (EIA). A guiding sheath was inserted from the left common femoral artery using the CTf3D-RM technique, and the occlusive vessel was clearly observed. The guidewire could be passed retrogradely without bidirectional wiring. The time taken to pass the guidewire was only about 9 min despite the long and hard chronic total occlusion (CTO). Intravascular ultrasound showed that all of the guidewire followed the intraplaque route. After ballooning the entire lesion, we deployed two stent grafts and three bare nitinol stents from the left CIA ostium to the distal EIA. Final angiography showed good expansion and sufficient flow to the left leg. Conclusions The use of a 3D roadmap by fusion of CT angiography with volumetric data from an angiography machine in EVT for iliac CTO was shown to be effective.

Transradial Intervention for Chronic Total Occlusion

2013 ◽  
Vol 111 (7) ◽  
pp. 19B
Author(s):  
Tsutomu Murakami ◽  
Naoki Masuda ◽  
Sho Torii ◽  
Makoto Natsumeda ◽  
Takeshi Ijichi ◽  
...  
Keyword(s):  
Chronic Total Occlusion ◽  
Total Occlusion ◽  
Transradial Intervention

scholarly journals The Wire Rendezvous and Chasing Wire Technique in the Bidirectional Approach for the Percutaneous Coronary Intervention for Chronic Total Occlusion with a Single Guiding Catheter

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Keisuke Nakabayashi ◽  
Daisuke Sunaga ◽  
Nobuhito Kaneko ◽  
Akihiro Matsui ◽  
Kazuhiko Tanaka ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Circumflex Artery ◽  
Total Occlusion ◽  
Left Circumflex Artery ◽  
Rendezvous Technique ◽  
Percutaneous Coronary ◽  
The Wire ◽  
Guiding Catheter

A bidirectional approach for percutaneous coronary intervention for chronic total occlusion (CTO-PCI) using ipsilateral collaterals with a single guiding catheter limits procedural choices. The CTO of the left circumflex artery with ipsilateral collateral artery was treated by the bidirectional approach using a single guiding catheter. While the retrograde wire directly crossed the CTO lesion, the microcatheter could not pass the CTO lesion despite the conventional strategies. Therefore, we performed the wire rendezvous and chasing wire techniques. The wire rendezvous technique enables deeper retrograde guidewire progression, and the antegrade microcatheter can reach the CTO entry. The chasing wire technique enables the antegrade guidewire to pass the route made by the retrograde guidewire. These techniques might offer a possible solution for bidirectional CTO-PCI using a single guiding catheter. However, this technique should be considered as a last resort because of the risk of rapid reocclusion.

scholarly journals Practical use of duplex echo-guided recanalization of chronic total occlusion in the iliac artery

2010 ◽  
Vol 52 (2) ◽  
pp. 475-478 ◽  
Author(s):  
Osami Kawarada ◽  
Yoshiaki Yokoi ◽  
Kazushi Takemoto
Keyword(s):  
Iliac Artery ◽  
Chronic Total Occlusion ◽  
Total Occlusion
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