Document Detail


Impact of aggressive endovascular recanalization techniques on success rate in chronic total arterial occlusions (CTOs).
MedLine Citation:
PMID:  20484077     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To report experience with aggressive recanalization approaches in chronic total arterial occlusion (CTO).
METHODS: Chronic total arterial occlusion recanalization was attempted on 112 limbs in 99 consecutive patients between January 1999 and December 2006.
RESULTS: There were 63 iliac arteries, 45 femoropopliteal arteries, and 4 occluded stents. Mean occlusion length was 8.7 ± 4.7 cm. Conventional recanalization was attempted first and was successful in 71 limbs (70%). Probing with the guidewire's stiff end was attempted in 33 of the 41 procedures where conventional techniques failed and was successful in 18 (54%), improving the overall procedural success rate to 80%. For the remaining 15 limbs, home-made directional sharp needle recanalization was attempted in 11 and was successful in 9 (82%), further improving the overall recanalization success to 88%. Procedural complications were self-limited or managed nonoperatively.
CONCLUSIONS: Aggressive recanalization techniques in CTO following failure of traditional means are safe and can substantially improve procedural success rates.
Authors:
Melhem J Sharafuddin; Jamal J Hoballah; Timothy F Kresowik; Rachael M Nicholson; William J Sharp
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Publication Detail:
Type:  Journal Article     Date:  2010-05-18
Journal Detail:
Title:  Vascular and endovascular surgery     Volume:  44     ISSN:  1938-9116     ISO Abbreviation:  Vasc Endovascular Surg     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-09-16     Completed Date:  2011-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136421     Medline TA:  Vasc Endovascular Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  460-7     Citation Subset:  IM    
Affiliation:
Department of Surgery, The University of Iowa Roy and Lucille Carver College of Medicine, Iowa City, IA 52242, USA. mel-sharafuddin@uiowa.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon* / adverse effects,  instrumentation
Arterial Occlusive Diseases / diagnosis,  physiopathology,  therapy*
Chi-Square Distribution
Chronic Disease
Constriction, Pathologic
Endovascular Procedures* / adverse effects,  instrumentation
Equipment Design
Female
Femoral Artery* / physiopathology
Humans
Iliac Artery* / physiopathology
Iowa
Kaplan-Meier Estimate
Logistic Models
Magnetic Resonance Angiography
Male
Middle Aged
Popliteal Artery* / physiopathology
Radiography, Interventional
Retrospective Studies
Stents
Time Factors
Treatment Outcome
Vascular Patency

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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