Subintimal angioplasty with a true reentry device for treatment of chronic total occlusion of the arteries of the lower extremity

Authors

  • Mohammad Shakil Aslam MD,

    1. Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin
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  • Suhail Allaqaband MD,

    1. Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin
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  • Babak Haddadian MD,

    1. Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin
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  • Naoyo Mori PHD,

    1. Center for Urban Population Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
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  • Tanvir Bajwa MD,

    1. Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin
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  • Mark Mewissen MD

    Corresponding author
    1. Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin
    • Correspondence to: Mark Mewissen, MD, 2801 W. Kinnickinnic River Pkwy. #540, Milwaukee, WI 53215. E-mail: publishing11@aurora.org

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  • Conflict of interest: None of the others have any conflicts of interest.

Abstract

Objective

To report the efficacy and safety of the Outback® LTD® Re-Entry Catheter in reentering the distal true lumen during percutaneous intentional extraluminal revascularization (PIER).

Background

Reentry catheters are used to treat chronic, total arterial occlusions of the lower extremities when standard methods of recanalization have failed. Success and complication rates of these catheters in the real world are uncertain and variable.

Methods

A retrospective review of our peripheral catheterization database from January 2004 to September 2009 was undertaken to identify consecutive cases of peripheral chronic total occlusions (CTOs) requiring the use of the Outback reentry catheter. Patient demographics, indication for the procedure, location and extent of occlusion, procedural success, and complications were studied.

Results

A total of 51 patients were identified. Of the 51, 28 (54.9%) patients presented with nonhealing ulcer and 22 (43.1%) had lifestyle-limiting claudication. One patient presented with acute limb ischemia. There were 6 (11.8%) patients with common iliac artery occlusion, 2 (3.9%) with external iliac artery occlusion, 1 (1.9%) with common femoral artery occlusion, 35 (68.6%) with superficial femoral artery occlusion, 6 (11.8%) with popliteal artery occlusion, and 1 (1.9%) with tibioperoneal artery occlusion. Median lesion length was 230 mm. Procedural success was achieved in 49 patients (96.1%). There was 1 (1.9%) periprocedural complication.

Conclusion

Use of Outback® LTD® Re-Entry Catheter is a safe and valuable option for PIER/subintimal angioplasty and recanalization in patients with symptomatic lower-extremity CTOs. However, long-term patency remains unknown. © 2012 Wiley Periodicals, Inc.

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