Subintimal angioplasty for superficial femoral artery occlusions: first experience in Kaunas University of Medicine Hospital

Objective. To assess prospectively the first experience of subintimal angioplasty of superficial femoral artery occlusions. Patients and methods. Within a period of 36 months, 45 patients with 45 chronic occlusions in superficial femoral artery were treated at Kaunas University of Medicine Hospital. Results. The technical success rate was 84.4%, and four failures were treated by conventional surgery. The following complications occurred: one hematoma at the arterial puncture site, one artery spasm, and two distal embolizations. The mean length of occlusions was 14.2±1.4 cm. The mean ankle-brachial index improved from 0.41±0.15 to 0.81±0.04 after successful subintimal angioplasty (P<0.001). Primary assisted patency rates were 94.7%, 92.1%, 84.2%, 81.6%, and 81.6% at 1, 3, 6, 12, and 24 months, respectively. The limb salvage rates were 100% and 97.8% at 1–3 and 6–12–24 months, respectively. There were no treatmentrelated amputations. Conclusions. Subintimal angioplasty of occluded superficial femoral artery is a safe and minimally invasive procedure with a high initial technical success rate, low complication rate, and good early results, and in case of failure, subsequent surgery can be performed.

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Technical success rate of uterine artery embolisation for treatment of uterine leiomyomas at the University of the Free State

South African Journal of Radiology ◽

10.4102/sajr.v6i2.1443 ◽

2002 ◽

Vol 6 (2) ◽

pp. 26-28

Author(s):

H. F. Potgieter ◽

C. S. De Vries ◽

E. Loggenberg

Keyword(s):

Success Rate ◽

Femoral Artery ◽

Uterine Artery ◽

Free State ◽

Uterine Artery Embolisation ◽

Technical Success ◽

Technical Success Rate ◽

The Mean ◽

The Right ◽

The University

The technical success rate of uterine artery embolisations at the Department of Diagnostic Radiology, University of the Free State (UFS) is reported. From November 1998 to July 2001, 67 women, aged 35 - 75 years, received uterine artery embolisation. The procedure was usually performed through a single 4-French sheath set which was introduced into the right femoral artery using a 4- French catheter and injecting PVC particles (150 - 550 micron). Embolisation was performed successfully in 85.5% of the women. The mean total fluoroscopy time was 16.8 minutes, ranging from 4.8 minutes to 47.3 minutes.

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Endoscopic Stricturotomy Is an Efficacious Option for Management of Strictures in Patients With Inflammatory Bowel Disease

Crohn's & Colitis 360 ◽

10.1093/crocol/otaa069 ◽

2020 ◽

Vol 2 (4) ◽

Author(s):

Nabeeha Mohy-ud-din ◽

Gursimran S Kochhar

Keyword(s):

Inflammatory Bowel Disease ◽

Success Rate ◽

Bowel Disease ◽

Chart Review ◽

Common Complication ◽

Technical Success ◽

Technical Success Rate ◽

Safe Technique ◽

Inflammatory Bowel ◽

The Mean

Abstract Background Strictures are a common complication for patients with inflammatory bowel disease. Endoscopic stricturotomy (ESt) is a novel procedure for treatment of these strictures. Methods A chart review was performed for patients with strictures who underwent ESt. Results Eleven patients were included in the study and the total number of strictures treated was 12. The mean length of the strictures was 10.25 ± 4.36 mm. Technical success was achieved in 92% (n = 11) of the procedures. Postprocedural bleeding occurred in 9% (n = 1) of patients, and none of the patients had complications of infection or perforation. Conclusions ESt is a safe technique with high technical success rate.

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Antegrade vs Crossover Femoral Artery Access in the Endovascular Treatment of Isolated Below-the-Knee Lesions in Patients With Critical Limb Ischemia

Journal of Endovascular Therapy ◽

10.1177/1526602817701251 ◽

2017 ◽

Vol 24 (3) ◽

pp. 331-336 ◽

Cited By ~ 3

Author(s):

Yukun Li ◽

Ali Esmail ◽

Konstantinos P. Donas ◽

Georgios Pitoulias ◽

Giovanni Torsello ◽

...

Keyword(s):

Endovascular Treatment ◽

Success Rate ◽

Femoral Artery ◽

Critical Limb Ischemia ◽

Limb Ischemia ◽

Technical Success ◽

Femoral Access ◽

Technical Success Rate ◽

Below The Knee ◽

Antegrade Approach

Purpose: To evaluate the safety and effectiveness of antegrade vs crossover femoral artery access in the endovascular treatment of isolated below-the-knee (BTK) lesions in patients with critical limb ischemia (CLI). Methods: Between January 2014 and December 2015, 224 high-risk patients (mean age 75.8±9.8 years; 151 men) with CLI underwent infragenicular interventions on 292 crural vessels in 3 European vascular centers. All patients had isolated TransAtlantic Inter-Society Consensus (TASC) C (n=26) or D (n=198) BTK lesions. Primary endpoints were freedom from access-related complications and technical success comparing the antegrade vs crossover access groups. Results: Balloon angioplasty was the most used treatment modality (169 vessels, 75.4%). The technical success rate was 88.4% in the entire cohort and 88.0% in the antegrade group vs 90.4% in the crossover group (p>0.99). In all patients, the technical success rate was higher for stenotic lesions (100%) vs occlusions (85.5%, p=0.002) and in patients with TASC C BTK lesions (100%) vs TASC D (86.9%, p=0.033). The overall freedom from access-related complications was 97.8%: 99% in the antegrade group and 90.6% in the crossover group (p=0.022). Larger sheath size (5/6-F vs 4-F) was associated with a significantly higher risk for access-related complications (7.1% vs 1.1%, respectively; p=0.047). Conclusion: The present multicenter study showed high technical success and a low incidence of access-related complications in the treatment of isolated BTK lesions using either antegrade or crossover femoral access. The antegrade approach with the use of a 4-F system seems to have a significantly lower rate of access-related complications.

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TRIACCESS study: randomized comparison between radial, femoral and transpedal access for for percutanous supertfitial femoral artery angioplasty

European Heart Journal ◽

10.1093/ehjci/ehaa946.2380 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

Z Ruzsa ◽

A Csavajda ◽

M Deak ◽

P Sotonyi ◽

O.F Bertrand ◽

...

Keyword(s):

Success Rate ◽

Femoral Artery ◽

Complication Rate ◽

Randomized Study ◽

Technical Success ◽

Access Site ◽

Femoral Access ◽

X Ray ◽

Technical Success Rate ◽

Access Site Complication

Abstract Background Traditional access for the treatment of femoral artery lesions is the femoral artery (FA) approach, but radial (RA) and pedal access (PA) is an alternative access site. The aim of the study was to compare the success rate, complication rate of different access sites for the treatment of superfitial artery stenosis in a randomized study Methods 180 consecutive patients were randomized in a prospective study to treat symptomatic superficial femoral stenosis, via RA, FA and PA. Primary endpoint: technical success, rate of major and minor access site complications. Secondary endpoints: major adverse events (MAE), procedural factors, cross-over rate, and duration of hospitalization. Results Technical success was achieved in 96.6%, 100% and 100% patients in RA, FA and PA group (p=ns). Secondary access site was used in 30%, 3.3% and 30% in the RA, FA and PA access group (p<0.01). Stent implantation was done in the femoral artery in 26.6%, 58.3% and 71.6% cases in RA, FA and PA group (p<0.01). CTO recanalization was performed in 34/36 (100%), 30/30 (100%) and 45/45 (100%) cases successfully in RA, FA and PA group (p=ns). Contrast consumption, fluoroscopy and procedure time was not statistically different, but the X Ray dose was significantly lower in PA than in the RA and FA access group (63.1 vs 162 vs 153 Dyn). The cumulative rate of access site complications in the RA, FA and PA group was 3.3% (0% major and 3.3% minor), 15% (3.3% major and 11.6% minor) and 3.3% (0% major and 3.3% minor) (p<0.01), respectively. The cumulative incidence of MAE's at 6 months in the RA, FA and PA group was 8.3% vs 13.3% and 18.3%. (p<0.05) Conclusion Femoral artery intervention can be safely and effectively performed using radial, femoral and pedal access, but radial and pedal access is associated with less access site complication rate. Pedal access is associated with less X Ray dose than radial and femoral access. Funding Acknowledgement Type of funding source: None

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Trans-Scapular Approach Coil Localization for Scapular-Blocked Pulmonary Nodules: A Retrospective Study

10.21203/rs.3.rs-98967/v1 ◽

2020 ◽

Author(s):

Juan Wu ◽

Min-Ge Zhang ◽

Jin Chen ◽

Wen-Bin Ji

Keyword(s):

Success Rate ◽

Thoracoscopic Surgery ◽

Pulmonary Nodules ◽

Adenocarcinoma In Situ ◽

Technical Failure ◽

Technical Success ◽

Ct Guided ◽

Technical Success Rate ◽

Preoperative Ct ◽

The Mean

Abstract Background: Preoperative computed tomography (CT)-guided coil localization (CL) is commonly employed to facilitate the video-assisted thoracoscopic surgery (VATS)-guided diagnostic wedge resection (WR) of pulmonary nodules (PNs). When a scapular-blocked PN (SBPN) will be localized, the trans-scapular CL (TSCL) should be performed. In this study, we investigated the safety, feasibility, and clinical efficacy of preoperative CT-guided TSCL for SBPNs.Materials and Methods: From January 2014 to September 2020, a total of 152 patients with PNs underwent CT-guided CL prior to VATS-guided WR. Among them, 14 patients had the SBPNs and underwent TSCL procedure. Results: A total of 14 SBPNs were localized in the 14 patients. The mean diameter of the 14 SBPNs was 7.4 ± 2.4 mm. Technical success rate of puncture of the scapula was 100%. No complications occurred near the scapula. Technical success rate of CL was 92.9%. One coil dropped off when performing the VATS procedure. The mean duration of the TSCL was 14.2 ± 2.7 min. Two patient (14.3%) developed aysmptomatic pneumothorax after TSCL. Technical success rate of VATS-guided WR was 92.9%. The patient who experienced technical failure of TSCL directly underwent lobectomy. The mean VATS procedure duration and blood loss were 90.0 ± 42.4 min and 62.9 ± 37.2 ml, respectively. The final diagnoses of the 14 SBPNs included invasive adenocarcinoma (n = 4), adenocarcinoma in situ (n = 9), and benign (n = 1).Conclusions: Preoperative CT-guided TSCL can be safely and simply used to facilitate high successful rates of VATS-guided WR of SBPNs.

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Abstract WP29: Early U.S. Experience with the Trevo Retriever Device: A Multi-Center Analysis

Stroke ◽

10.1161/str.44.suppl_1.awp29 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Michael J Alexander ◽

Erol Veznedaroglu ◽

Lei Feng ◽

Gary Duckwiler ◽

Adnan Siddiqui ◽

...

Keyword(s):

Success Rate ◽

Clinical Results ◽

Technical Success ◽

Femoral Access ◽

Technical Success Rate ◽

Clinical Exam ◽

Post Procedure ◽

The Mean ◽

Number Of Passes ◽

Mean Time

Introduction: The Trevo Retriever device (Stryker Neurovascular, Mountain View, CA) received FDA clearance as a 510K device in August 2012 for clot retrieval in acute ischemic stroke within eight hours of symptom onset. This study is an early look at the initial U.S. experience with the device following FDA clearance, examining the clinical results of the some of the first cases performed in the U.S. Methods: This was a retrospective analysis of prospectively collected clinical data from the early U.S. experience using the Trevo Retriever device. All physician operators were in-serviced on the use of the device and technique prior to first clinical use. Of the first patients treated, 6 were MCA occlusions, and 1 ICA occlusion. Four of the patients received intravenous tPA prior to their intervention, the remaining three patients did not did not qualify for IV tPA. The mean NIHSS pre-procedure was 19. Results: The Trevo device could be delivered across the intraluminal clot in all seven cases. There was a 100% success rate in revascularization of the target territory as judged by TICI score 2b or 3. One case resulted in an ACA embolus that was successfully revascularized. There was an average of 2.0 passes of the device to achieve this revascularization rate (range 1-4), with 71% of the cases needing 1 or 2 passes, and the remaining 3 or 4 passes. The mean time from femoral access to revascularization was 44 minutes (range 18-93 minutes, median 31 minutes). The average clot length was 11 mm. The clot was characterized as soft/friable in 2 cases, intermediate/rubbery in 3 cases, and hard/fibrous in 2 cases. The 24 hour post-procedure NIHSS was improved in 86% of the patients treated, and the mean NIHSS at 24 hours was 10 (range 0-27). Five of the seven patients had an improvement on the NIHSS of 9 points or greater. Conclusions: The technical success rate, as measured by a TICI score of 2b or 3, was excellent (100%) in this initial U.S. experience. With a high revascularization rate and a few number of passes, this shortened the endovascular revascularization time, and resulted in improved clinical exam in 6 of the 7 patients within 24 hours post-procedure.

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Comparison of the Results of Percutaneous Transluminal Angioplasty and Stenting with Medical Treatment for Claudicants Who Have Superficial Femoral Artery Occlusive Disease

Vascular ◽

10.2310/6670.2006.00017 ◽

2006 ◽

Vol 14 (2) ◽

pp. 81-87 ◽

Cited By ~ 8

Author(s):

Samuel Wilson ◽

Dmitri Gelfand ◽

Juan Jimenez ◽

Ian Gordon

Keyword(s):

Medical Treatment ◽

Femoral Artery ◽

Superficial Femoral Artery ◽

Percutaneous Transluminal Angioplasty ◽

Ankle Brachial Index ◽

Transluminal Angioplasty ◽

Walking Distance ◽

Control Group ◽

Early Results ◽

Percutaneous Transluminal

The outcomes of medical management of peripheral vascular disease localized to the superficial femoral artery (SFA) were compared with those obtained by percutaneous transluminal angioplasty (PTA) with or without stenting in a review of selected studies. The natural history of localized SFA disease is favorable, with major amputation rates less than 10% and revascularization in only 18% of patients over a 10-year interval. Conservative treatment of claudicants shows increases (150%) in walking distance if the ankle brachial index (ABI) is over 0.6 and patients stop smoking. Analysis of 10 trials (882 patients) of PTA with or without stenting found that the overall primary patency rates at 12 months were 71.1% for PTA plus stenting and 58.3% for PTA alone. Technical success with PTA with or without stenting is over 90%, and early results at 6 months are superior to those with exercise. In three randomized controlled trials, however, the difference between PTA and medical treatment at 2 years, whether measured by walking distance or ABI, was not significant, nor was the quality of life. For long-term improvement in walking distance (> 1 year) in the claudicant, intervention is not superior to medical treatment and a monitored exercise program. Consideration should be given to including a nonintervention control group and 2-year outcomes in the evaluation of new SFA stents.

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Ultrasound-Guided Percutaneous Thermal Ablation of Hepatic Focal Nodular Hyperplasia——A Multicenter Retrospective Study

Frontiers in Bioengineering and Biotechnology ◽

10.3389/fbioe.2021.826926 ◽

2022 ◽

Vol 9 ◽

Author(s):

Xuan Yu ◽

Jiandong Chang ◽

Dezhi Zhang ◽

Qiang Lu ◽

Songsong Wu ◽

...

Keyword(s):

Success Rate ◽

Focal Nodular Hyperplasia ◽

Thermal Ablation ◽

Efficacy Rate ◽

Technical Success ◽

Technical Success Rate ◽

Nodular Hyperplasia ◽

Percutaneous Thermal Ablation ◽

The Mean

Background and Aim: To evaluate the clinical effect of ultrasound (US)-guided percutaneous thermal ablation of hepatic focal nodular hyperplasia (FNH).Methods: A retrospective analysis of the clinical data of patients undergoing US-guided percutaneous thermal ablation of FNH from November 2008 to August 2021 at five medical centers in China was conducted.Results: A total of 53 patients were included (26 males and 27 females). The mean age was 35.1 ± 10.8 years. Sixty-five lesions (46 solitary cases and 7 cases with multiple lesions) were included, 70.8% (46/65) of which were located in the right liver lobe. The mean tumor length was 2.9 ± 1.5 cm. All patients successfully completed the ablation treatment. Immediate postoperative imaging showed that the primary technical success rate was 94.3% (50/53). Two patients underwent ablation 3 and 6 months after the primary ablation, and the secondary technical success rate was 100% (2/2). The incidence of complications was 3.8% (2/53). Imaging follow-up was conducted regularly after ablation, and no residual lesion enlargement or tumor recurrence was observed during the follow-up period. The technique efficacy rate was 98.1% (52/53).Conclusion: US-guided percutaneous thermal ablation is a safe and effective treatment for FNH of the liver.

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Comparison of Ultrasound-Accelerated Versus Multi-Hole Infusion Catheter-Directed Thrombolysis for the Treatment of Acute Limb Ischemia

Vascular and Endovascular Surgery ◽

10.1177/1538574419861768 ◽

2019 ◽

Vol 53 (7) ◽

pp. 558-562 ◽

Cited By ~ 2

Author(s):

Jesse Chait ◽

Afsha Aurshina ◽

Natalie Marks ◽

Anil Hingorani ◽

Enrico Ascher

Keyword(s):

Success Rate ◽

Limb Ischemia ◽

Limb Loss ◽

Acute Limb Ischemia ◽

Technical Success ◽

Safety And Efficacy ◽

Technical Success Rate ◽

Infusion Catheter ◽

Catheter Directed Thrombolysis ◽

The Mean

Objective: Thrombolytic therapy is widely used in the treatment of arterial occlusions causing acute limb ischemia (ALI); however, knowledge regarding the efficacy of the different catheter systems available is scarce. The objective of this study was to compare the safety and efficacy of 2 catheter-directed infusion systems for intra-arterial thrombolysis in the setting of ALI. Methods: A retrospective analysis was conducted to study all catheter-directed thrombolysis procedures performed over 32 months in patients diagnosed with ALI. Patients with thrombosis in both native arteries and bypass grafts were included. Patients with contraindications to thrombolysis, or those receiving thrombolysis for deep venous thrombosis, were excluded. The duration of thrombolysis, amount of thrombolytic agent, and technical success rate were recorded. Technical success was defined as complete or near-complete resolution of thrombus burden, allowing for further intervention. Data were stratified to include location of thrombus, procedural complications, mortality, and rates of limb loss. Results: Ninety-one patients met inclusion criteria. Among them, Uni-Fuse and EKOS catheters were used in 69 and 22 patients, respectively. The mean age of the population was 71 (standard deviation [SD]: ±1.5) for patients treated with the EKOS catheter and 70 years (SD: ±2.6) for patients receiving thrombolysis with Uni-Fuse. There was no significant difference in the mean infusion duration (1.65 vs 1.9 days), volume of tissue plasminogen activator (44.6 vs 48.2 mg), or technical success rate (72% vs 86%) between the Uni-Fuse and EKOS cohorts ( P > .3). Furthermore, there was no difference in major limb loss or compartment syndrome between each group ( P > .4). The overall complication rate was 14% in both groups, with a 30-day mortality rate of 4% when treated with either catheter system. Conclusion: This study suggests that a standard multi-hole infusion catheter demonstrates similar clinical safety and efficacy as the ultrasound-accelerated EKOS system in the treatment of ALI.

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The influence of various factors on results of subintimal angioplasty of superficial femoral artery occlusions

Medicina ◽

10.3390/medicina43010006 ◽

2007 ◽

Vol 43 (1) ◽

pp. 43 ◽

Cited By ~ 4

Author(s):

◽

Rytis Kaupas

Keyword(s):

Diabetes Mellitus ◽

Medical Treatment ◽

Femoral Artery ◽

Superficial Femoral Artery ◽

Cardiac Disease ◽

Arterial Calcification ◽

Chronic Ischemia ◽

Technical Success ◽

Subintimal Angioplasty ◽

The Impact

Objective. To evaluate prospectively the impact of various factors on subintimal angioplasty of superficial femoral artery. Patients and methods. Within a period of 36 months, 44 patients with 45 chronic occlusions in superficial femoral artery were examined. The influence of sex, age, hypertension, diabetes mellitus, smoking, chronic ischemia stage, occlusion length and calcification, flush occlusion of the superficial femoral artery, ischemic cardiac disease, postprocedural medical treatment was evaluated. Results. Arterial calcification had a significant impact on technical success of subintimal angioplasty (p=0.03). Sex, age, smoking, flush occlusion of the superficial femoral artery, and cardiac disease influenced technical and hemodynamic success (p=0.086–0.295). Hypertension, diabetes mellitus, chronic ischemia stage, occlusion length, and postprocedural medical treatment did not significantly influence technical and hemodynamic success (p>0.05). Conclusions. Arterial calcification had a significant impact on technical success of subintimal angioplasty. Sex, age, smoking, flush occlusion of the superficial femoral artery, and ischemic cardiac disease influenced technical and hemodynamic success. Hypertension, diabetes mellitus, chronic ischemia stage, occlusion length, and postprocedural medical treatment had no statistically significant impact on technical and hemodynamic success.

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