scholarly journals Abstract No. 13 Nontraumatic intraluminal recanalization of difficult below-the-knee total occlusions using combination of intravascular ultrasound catheter tip and long supporting vascular sheath

2021 ◽  
Vol 32 (5) ◽  
pp. S7
Author(s):  
K. Zhang
Keyword(s):  
Intravascular Ultrasound ◽  
Below The Knee ◽  
Vascular Sheath ◽  
Catheter Tip

scholarly journals Transvenous Intravascular Ultrasound–Guided Endovascular Treatment for Chronic Total Occlusion of the Infrainguinal Arteries

2017 ◽  
Vol 24 (5) ◽  
pp. 718-726 ◽  
Author(s):  
Yasuhiro Takahashi ◽  
Taisuke Sato ◽  
Hirotake Okazaki ◽  
Ayaka Nozaki ◽  
Masato Matsushita ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Chronic Total Occlusion ◽  
Treatment Strategies ◽  
Target Lesion ◽  
Total Occlusion ◽  
Below The Knee ◽  
Infrainguinal Arteries ◽  
Primary Success ◽  
Grade 3

Purpose: To investigate the 1-year outcomes of transvenous intravascular ultrasound (IVUS)–guided endovascular therapy (EVT) for chronic total occlusion (CTO) of the lower extremity arteries. Methods: Transvenous IVUS-guided EVT was performed in 44 patients (50 limbs) with CTO of the femoropopliteal arteries or tibioperoneal trunk. Treatment involved crossing a guidewire through the CTO under the guidance of both fluoroscopic and IVUS imaging, along with insertion of the IVUS catheter into a vein parallel to the target artery. Primary success rate, complications, and target lesion revascularization (TLR) at 12-month follow-up were investigated. Results: Successful recanalization, defined as grade 3 flow (Thrombolysis in Myocardial Infarction score) and no flow-limiting dissection, was observed in 48 (96%) limbs. Two limbs with failed recanalization had a very long CTO lesion from the superficial femoral artery to below the knee. A bidirectional approach was selected in 11 (22%) limbs. Complications at the access site occurred in only 2 patients. The rate of freedom from TLR at 12 months was 77.9% (95% confidence interval 61.4 to 87.9). Conclusion: Transvenous IVUS-guided EVT is safe and can provide optimal short-term results for EVT of CTO in the infrainguinal arteries. IVUS-guided EVT may be one of the most effective treatment strategies for CTO of the femoropopliteal arteries or tibioperoneal trunk.

PP-213 A BROKEN INTRAVASCULAR ULTRASOUND CATHETER TIP IN CORONARY ARTERY: A CHALLENGING COMPLICATION NOBODY WANTS TO MEET

2012 ◽  
Vol 155 ◽  
pp. S171
Author(s):  
A. Iyisoy ◽  
M. Celik ◽  
T. Celik ◽  
U.C. Yuksel ◽  
B. Bugan ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Intravascular Ultrasound ◽  
Catheter Tip

scholarly journals Radiofrequency ablation of anteroseptal accessory pathway: A challenge to the electrophysiologist

2015 ◽  
Vol 72 (4) ◽  
pp. 375-378
Author(s):  
Mihailo Vukmirovic ◽  
Lazar Angelkov ◽  
Filip Vukmirovic ◽  
Irena Tomasevic-Vukmirovic
Keyword(s):  
High Risk ◽  
Energy Levels ◽  
Accessory Pathway ◽  
Football Player ◽  
Av Block ◽  
His Bundle ◽  
Vascular Sheath ◽  
Catheter Tip ◽  
Rf Energy ◽  
Very High

Introduction. Anteroseptal accessory pathways (APs) are located in the apex of the triangle of Koch?s connecting the atrial and ventricular septum in the region of the His bundle. Ablation of anteroseptal pathway locations remains a challenge to the electrophysiologist due to a very high risk of transiet or permanent atrioventricular (AV) block. Case report. A male, 18-year-old, patient was hospitalized due to radiofrequency (RF) ablation of APs. He was an active football player with frequent palpitations during efforts accompanied by dyspnea and lightheadedness, but without syncope. Electrocardiography on admission showed intermittent preexcitations. Intracardiac mapping showed the earliest ventricular activation that preceded surface electrocardiographic delta wave in anteroseptal region very close to the AV node and His bundle. Using a long vascular sheath for stabilization of the catheter tip, RF energy was delivered at the target site starting at very low energy levels and because of the absence of either PR prolongation, as well as accelerated junctional rhythm during the first 15 sec, the power was gradually increased to 40W, so after application RF energy preexcitation was not registered. Conclusion. Despite this proximity to the His bundle and very high risk of transiet or permanent AV block anteroseptal APs can still be ablated successfully.

Intravascular Ultrasound–Guided Interventions for Below-the-Knee Disease in Patients With Chronic Limb-Threatening Ischemia

2020 ◽  
Vol 27 (4) ◽  
pp. 565-574
Author(s):  
Masahiko Fujihara ◽  
Yuko Yazu ◽  
Mitsuyoshi Takahara
Keyword(s):  
Wound Healing ◽  
Limb Salvage ◽  
Intravascular Ultrasound ◽  
Ankle Brachial Index ◽  
Target Lesion ◽  
Complication Rates ◽  
Technical Success ◽  
Propensity Score Matching Analysis ◽  
Below The Knee ◽  
Balloon Size

Purpose: To assess the utility of intravascular ultrasound (IVUS) during below-the-knee (BTK) interventions for patients with chronic limb-threatening ischemia (CLTI). Materials and Methods: This retrospective single-center study included 216 symptomatic patients (mean age 74.2±9.5 years; 167 men) with CLTI and BTK steno-occlusive disease who underwent successful balloon angioplasty between January 2016 and August 2018. Data from 88 vessels (58 patients) treated with IVUS-guided procedures were compared with corresponding values from 242 vessels (158 patients) treated with angiography-guided procedures. The primary outcomes included procedure-related variables of balloon size, contrast dose, and complication rates, as well as changes in ankle-brachial index (ABI) and skin perfusion pressure (SPP). Secondary outcomes included IVUS determination of vessel size, wire route, and calcification severity, as well as technical success and clinically-driven target lesion revascularization (TLR), limb salvage, and wound healing rates in the Rutherford category 5/6 patients as evaluated by propensity score matching analysis. Results: The patient and lesion characteristics were similar in both groups. The mean balloon size for IVUS-guided procedures was significantly larger (2.45±0.4 mm) compared with that for angiography-guided procedures (2.23±0.4 mm; p<0.001). The technical success (p=0.56) and complication rates (p=0.16) were similar between the groups. The postprocedure dorsal and plantar SPP and change in dorsal SPP improved more in the IVUS-guided group (p<0.001, p=0.015, and p=0.02, respectively). The IVUS-guided group had a significantly better wound healing rate than the angiography-guided group (p=0.006), although the freedom from TLR and limb salvage rates were similar between the groups (p=0.16 and p>0.99, respectively). Conclusion: IVUS-guided interventions for BTK lesions were safe and effective in accurately assessing the lesions. The results suggest that IVUS guidance of endovascular procedures has the potential to influence better clinical outcomes than angiography-guided angioplasty.

Successful retrieval of a broken intravascular ultrasound catheter tip from a coronary artery

2012 ◽  
Vol 13 (4) ◽  
pp. 238-240 ◽  
Author(s):  
Atila Iyisoy ◽  
Murat Celik ◽  
Turgay Celik ◽  
Uygar Cagdas Yuksel ◽  
Samed Samedli
Keyword(s):  
Coronary Artery ◽  
Intravascular Ultrasound ◽  
Catheter Tip ◽  
Successful Retrieval

Intravascular ultrasound in the diagnosis and treatment of central venous diseases

VASA ◽  
2021 ◽  
Vol 50 (1) ◽  
pp. 2-10 ◽  
Author(s):  
Xin Li ◽  
Giuseppe D’Amico ◽  
Cristiano Quintini ◽  
Teresa Diago Uso ◽  
Sameer Gadani ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Patient Outcomes ◽  
Controlled Trials ◽  
Ivc Filter ◽  
Venous Anatomy ◽  
Central Venous ◽  
Detailed Measurement ◽  
Filter Placement ◽  
Randomized Controlled ◽  
Venous Diseases

Summary: Intravascular ultrasound (IVUS) has been used extensively in coronary applications. Its use in venous applications has increased as endovascular therapy has increasingly become the mainstay therapy for central venous diseases. IVUS has been used for both diagnostic and therapeutic purposes in managing venous stenotic disease, venous occlusive disease, and IVC filter placement and removal. IVUS has been proven to be effective in providing detailed measurement of the venous anatomy, which aid in determining the appropriate size and the approach for venous stent placement. In IVC filter placement, IVUS can provide detailed measurement and guide IVC filter placement in emergent and critical care settings. It also has certain utility in filter removal. At any rate, to date there are only a few studies examining its impact on patient outcomes. Prospective randomized controlled trials are warranted in the future.

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