scholarly journals TCTAP C-191 Successful Revascularization for Long Chronic Total Occlusion from External Iliac Artery to Superficial Femoral Artery by Multidirectional Approach via Failed Femoro-femoral and Femoropopliteal Artery Bypass Grafting

2018 ◽  
Vol 71 (16) ◽  
pp. S263-S264
Author(s):  
Takaesu Satoru
Author(s):  
Florian Rey ◽  
Sophie Degrauwe ◽  
Stéphane Noble ◽  
Juan F Iglesias

Abstract Physiological assessment is challenging in patients with multivessel disease (MVD) with a chronic total occlusion (CTO) and may result in inappropriate treatment decisions. We report herein, for the first time to our knowledge, on the dynamic changes of the instantaneous wave-free ratio in the CTO collateral donor artery before and after coronary artery bypass grafting (CABG). Our case highlights the paramount importance of collateral circulation when interpreting invasive indices of coronary stenosis severity to guide decision-making for CABG in MVD patients with a CTO. This may be particularly relevant to reduce the risk of early graft failure in patients with MVD undergoing CABG.


2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Justin Ratcliffe ◽  
Mike Gorenchtein ◽  
Pankaj Khullar ◽  
Abel Casso Dominguez ◽  
Mohan Satish ◽  
...  

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.


2019 ◽  
Vol 7 ◽  
pp. 2050313X1983415
Author(s):  
Taketsugu Tsuchiya ◽  
Minako Oda ◽  
Takaaki Takamura ◽  
Katsuhide Kitagawa ◽  
Koji Kajinami ◽  
...  

Early 80s male with intermitted claudication underwent endovascular therapy for atherosclerotic stenosis at left external iliac artery and middle of superficial femoral artery. Patient also had chronic atrial fibrillation, diabetes mellitus, and hypertension. After stent deployment for external iliac artery lesion, a short superficial femoral artery lesion was performed with angioplasty using drug-coated balloon. The drug-coated balloon angioplasty resulted in 50% residual stenosis with linear dissection; however, provisional stenting was not performed as decent ante-grade blood flow allowed 10 extra minutes. Medication involved ongoing use of aspirin 100 mg and rivaroxaban 15 mg. Angiography post 3 months from index procedure showed external iliac artery and superficial femoral artery patency and healing of intimal dissection at superficial femoral artery lesion was estimated by intravascular ultrasonography. In angioscopy findings, red thrombus was seen in dissection cavity.


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