Document Detail

Safety and short-term outcomes following controlled blunt microdissection revascularization of symptomatic arterial occlusions of the pelvis and lower extremities.
MedLine Citation:
PMID:  19944982     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To present the safety and short-term outcomes of using controlled blunt microdissection catheter-assisted revascularization of symptomatic chronic total occlusions of the lower extremity. MATERIALS AND METHODS: A retrospective study was performed on 61 patients (46 men) with a mean age of 72.3 years +/- 9.4 who underwent 67 procedures in 86 arteries between June 2003 and March 2007 for claudication (38 procedures, 57%), rest pain (19 procedures, 28%), and tissue loss (10 procedures, 15%). Technical success was defined as successful traversal of the occlusion. Duplex ultrasonography (US) was used to assess patency. Clinical patency was defined as at least one category improvement in Rutherford score from baseline and absence of target limb revascularization or major amputation at 6 months. RESULTS: Chronic total occlusions were located in aortoiliac (11 arteries, 13%), infrainguinal (72 arteries, 83%), and infrapopliteal (four arteries, 5%) arteries. The mean lesion length was 14.2 cm +/- 8. The tibial run-off vessels was 1.9 vessels +/- 0.8. The technical success rate of the procedure was 84%. Advanced age (P = .04), renal function (P = .02), and target lesion length (P < or = .01) were predictors of technical failure. The clinical success rate at 6 months was 92%, and the primary patency with duplex US was 87%. Renal function (P < or = .01), length of the occlusion (P < or =.01), number of stents per procedure (P < or =.01), and tibial run-off vessels (P = .05) were the predictors of clinical success. CONCLUSIONS: The controlled blunt microdissection catheter is safe in the revascularization of chronic total occlusions of the lower extremity. The technical success rate was 84% and predicted by age, renal function, and lesion characteristics. Clinical patency at 6 months was 92% and predicted by renal function, lesion characteristics, and run-off.
Mallik R Thatipelli; Sanjay Misra; Srinivas R Sanikommu; Robert M Schainfeld; Peter A Soukas
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  20     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-30     Completed Date:  2010-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1541-7     Citation Subset:  IM    
Section of Vascular Medicine, St Elizabeth's Medical Center, Boston, Massachusetts, USA.
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MeSH Terms
Age Factors
Arterial Occlusive Diseases / diagnosis,  physiopathology,  surgery*
Catheterization, Peripheral* / adverse effects
Chronic Disease
Constriction, Pathologic
Kaplan-Meiers Estimate
Kidney / physiopathology
Lower Extremity / blood supply*
Microdissection* / adverse effects
Pelvis / blood supply*
Radiography, Interventional
Retrospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Surgical Procedures, Minimally Invasive
Time Factors
Treatment Outcome
Ultrasonography, Doppler, Duplex
Vascular Patency

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

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