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- Title
Transvenous Intravascular Ultrasound-Guided Endovascular Treatment for Chronic Total Occlusion of the Infrainguinal Arteries.
- Authors
Takahashi, Yasuhiro; Sato, Taisuke; Okazaki, Hirotake; Nozaki, Ayaka; Matsushita, Masato; Kamiya, Masataka; Shimizu, Wataru
- Abstract
<bold>Purpose: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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).<bold>Conclusion: </bold>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.
- Publication
Journal of Endovascular Therapy, 2017, Vol 24, Issue 5, p718
- ISSN
1526-6028
- Publication type
journal article
- DOI
10.1177/1526602817723139