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A Novel Device for True Lumen Re-Entry After Subintimal Recanalization of Superficial Femoral Arteries: First-in-Man Experience and Technical Description

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Abstract

Subintimal angioplasty (SAP) is frequently performed for the treatment of critical limb ischemia (CLI) and has been recognized as an effective technique for these patients. Nevertheless, this approach is limited by the lack of controlled re-entry into the true lumen of the target vessel. We describe a novel device for true lumen re-entry after subintimal recanalization of superficial femoral arteries (SFA). We report our experience with six patients treated between April 2009 and January 2010 with a novel system designed to facilitate true lumen re-entry. The device was advanced by ipsilateral antegrade approach through a 6-French sheath. Successful reaccess into the true lumen was obtained in five of six patients without complications. The patient in whom the reaccess to the true lumen was not possible underwent successful bypass surgery. At 30 days follow-up, the SFA was patent in all patients according to echo-Doppler examination. Our preliminary experience indicates that this novel re-entry device increases the success rate of percutaneous revascularization of chronically occluded SFA.

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References

  1. Spinosa DJ, Harthun NL, Bissonette EA et al (2005) Subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) for subintimal recanalization to treat chronic critical limb ischemia. J Vasc Interv Radiol 16:37–44

    PubMed  Google Scholar 

  2. Setacci C, Chisci E, de Donato G et al (2009) Subintimal angioplasty with the aid of a re-entry device for TASC C and D lesions of the SFA. Eur J Vasc Endovasc Surg 38:76–87

    Article  CAS  PubMed  Google Scholar 

  3. Laxdal E, Jenssen GL, Pedersen G, Aune S (2003) Subintimal angioplasty as a treatment of femoropopliteal artery occlusions. Eur J Vasc Endovasc Surg 25:578–582

    Article  CAS  PubMed  Google Scholar 

  4. Met R, Van Lienden KP, Koelemay MJ, Bipat S et al (2008) Subintimal angioplasty for peripheral arterial occlusive disease: a systematic review. Cardiovasc Intervent Radiol 31:687–697

    Article  PubMed  Google Scholar 

  5. Hynes N, Akhtar Y, Manning B et al (2004) Subintimal angioplasty as a primary modality in the management of critical limb ischemia: comparison to bypass grafting for aortoiliac and femoropopliteal occlusive disease. J Endovasc Ther 11:460–471

    Article  PubMed  Google Scholar 

  6. Saket RR, Razavi MK, Padidar A et al (2004) Novel intravascular ultrasound-guided method to create transintimal arterial communications: initial experience in peripheral occlusive disease and aortic dissection. J Endovasc Ther 11:274–280

    Article  PubMed  Google Scholar 

  7. Wiesinger B, Steinkamp H, Konig C et al (2005) Technical report and preliminary clinical data of a novel catheter for luminal re-entry after subintimal dissection. Invest Radiol 40:725–728

    Article  PubMed  Google Scholar 

  8. Hausegger KA, Georgieva B, Portugaller H et al (2004) The outback catheter: a new device for true lumen re-entry after dissection during recanalization of arterial occlusions. Cardiovasc Intervent Radiol 27:26–30

    Article  PubMed  Google Scholar 

  9. Husmann M, Federer J, Keo HH et al (2009) Bailout revascularization of chronic femoral artery occlusions with the new outback catheter following failed conventional endovascular intervention. J Endovasc Ther 16:206–212

    Article  PubMed  Google Scholar 

  10. Ramjas G, Thurley P, Habib S et al (2008) The use of a re-entry catheter in recanalization of chronic inflow occlusions of the common iliac artery. Cardiovasc Intervent Radiol 31:650–654

    Article  PubMed  Google Scholar 

  11. Charalambous N, Schäfer PJ, Trentmann J et al (2010) Percutaneous intraluminal recanalization of long, chronic superficial femoral and popliteal occlusions using the Frontrunner XP CTO device: a single-center experience. Cardiovasc Intervent Radiol 33:25–33

    Article  PubMed  Google Scholar 

  12. Norgren L, Hiatt WR, Dormandy JA et al (2007) Inter-society consensus for the management of peripheral arterial disease (TASC II). Eur J Vasc Endovasc Surg 33(Suppl 1):S1–75

    Article  PubMed  Google Scholar 

  13. Rutherford RB, Baker JD, Ernst C et al (1997) Recommended standards for reports dealing with lower extremity ischemia: revised version. J Vasc Surg 26:517–538

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Cardiovascular Department, Multimedica IRCCS, Via Milanese, 300, Sesto San Giovanni (MI), 20099, Italy

    Flavio Airoldi, Ezio Faglia, Sergio Losa, Davide Tavano, Manuela Mantero, Gaetano Lanza & Giacomo Clerici

  2. Division of Cardiology, University of Cape Town, Cape Town, South Africa

    Azeem Latib

Authors
  1. Flavio Airoldi
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  2. Ezio Faglia
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  3. Sergio Losa
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  4. Davide Tavano
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  5. Azeem Latib
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  6. Manuela Mantero
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  7. Gaetano Lanza
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  8. Giacomo Clerici
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Correspondence to Flavio Airoldi.

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Airoldi, F., Faglia, E., Losa, S. et al. A Novel Device for True Lumen Re-Entry After Subintimal Recanalization of Superficial Femoral Arteries: First-in-Man Experience and Technical Description. Cardiovasc Intervent Radiol 34, 166–169 (2011). https://doi.org/10.1007/s00270-010-9859-1

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  • DOI: https://doi.org/10.1007/s00270-010-9859-1

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