Bailout revascularization of chronic femoral artery occlusions with the new outback catheter following failed conventional endovascular intervention

Husmann, Marc; Federer, Jonas; Keo, Hak Hong; Schmidli, Jürg; Kickuth, Ralph; Baumgartner, Iris; Do, Dai-Do (2009). Bailout revascularization of chronic femoral artery occlusions with the new outback catheter following failed conventional endovascular intervention. Journal of endovascular therapy, 16(2), pp. 206-12. Phoenix, Ariz.: International Society of Endovascular Specialists 10.1583/08-2496.1

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PURPOSE: To report the application of a true lumen re-entry device in the bailout treatment of chronic total occlusions (CTO) of the superficial femoral artery (SFA) after failed angioplasty. METHODS: Nineteen patients (12 men; mean age 81 years, range 61-97) with 20 SFA CTOs and Rutherford category 2 to 5 ischemia were prospectively evaluated. All CTOs had unsuccessful recanalization using conventional techniques and were subsequently treated with the Outback LTD catheter. Follow-up at 3, 6, and 12 months included ankle/toe pressure measurement and pulse volume recordings. Endpoints were revascularization rate, target lesion revascularization, and limb salvage. RESULTS: Revascularization was achieved in 95% of the cases. There were 2 (10%) periprocedural complications unrelated to the re-entry device, which were resolved by endovascular or surgical treatment. The target lesion revascularization rate was 10%, with the 2 events occurring at 3 and 6 months, respectively, in patients with Rutherford category 4-5 ischemia. There was one below-the-knee amputation in the patient with failed revascularization. CONCLUSION: The acute failure of endovascular treatment of SFA CTOs is most often due to an inability to re-enter the true lumen after the occlusion is crossed in a subintimal plane. Bailout revascularization with the Outback LTD catheter is highly successful and shows a low device-related complication rate. This needle- and fluoroscopic-based re-entry device increases the endovascular success rate and is therefore expanding the minimally invasive treatment options for surgically unfit patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery

UniBE Contributor:

Keo, Hak Hong; Schmidli, Jürg; Baumgartner, Iris and Do, Dai-Do

ISSN:

1526-6028

Publisher:

International Society of Endovascular Specialists

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:12

Last Modified:

04 May 2014 23:23

Publisher DOI:

10.1583/08-2496.1

PubMed ID:

19456187

Web of Science ID:

000266567700013

URI:

https://boris.unibe.ch/id/eprint/31722 (FactScience: 196382)

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