Impact of aggressive endovascular recanalization techniques on success rate in chronic total arterial occlusions (CTOs)

Melhem J Sharafuddin; Jamal J Hoballah; Timothy F Kresowik; Rachael M Nicholson; William J Sharp

doi:10.1177/1538574410370375

Back

Impact of aggressive endovascular recanalization techniques on success rate in chronic total arterial occlusions (CTOs)

Journal article

Peer reviewed

Impact of aggressive endovascular recanalization techniques on success rate in chronic total arterial occlusions (CTOs)

Melhem J Sharafuddin, Jamal J Hoballah, Timothy F Kresowik, Rachael M Nicholson and William J Sharp

Vascular and endovascular surgery, Vol.44(6), pp.460-467

08/2010

DOI: 10.1177/1538574410370375

PMID: 20484077

View Online

Abstract

To report experience with aggressive recanalization approaches in chronic total arterial occlusion (CTO). Chronic total arterial occlusion recanalization was attempted on 112 limbs in 99 consecutive patients between January 1999 and December 2006. 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. Aggressive recanalization techniques in CTO following failure of traditional means are safe and can substantially improve procedural success rates.

Radiography, Interventional

Arterial Occlusive Diseases - diagnosis

Constriction, Pathologic

Humans

Middle Aged

Male

Angioplasty, Balloon - adverse effects

Equipment Design

Endovascular Procedures - instrumentation

Time Factors

Popliteal Artery - physiopathology

Female

Retrospective Studies

Arterial Occlusive Diseases - physiopathology

Stents

Endovascular Procedures - adverse effects

Femoral Artery - physiopathology

Kaplan-Meier Estimate

Magnetic Resonance Angiography

Logistic Models

Treatment Outcome

Chi-Square Distribution

Angioplasty, Balloon - instrumentation

Iowa

Aged

Iliac Artery - physiopathology

Chronic Disease

Arterial Occlusive Diseases - therapy

Vascular Patency

Details

Title: Subtitle: Impact of aggressive endovascular recanalization techniques on success rate in chronic total arterial occlusions (CTOs)
Creators: Melhem J Sharafuddin - Department of Surgery, The University of Iowa Roy and Lucille Carver College of Medicine, Iowa City, IA 52242, USA. mel-sharafuddin@uiowa.edu
Jamal J Hoballah
Timothy F Kresowik
Rachael M Nicholson
William J Sharp
Resource Type: Journal article
Publication Details: Vascular and endovascular surgery, Vol.44(6), pp.460-467
Publisher: United States
DOI: 10.1177/1538574410370375
PMID: 20484077
ISSN: 1538-5744
eISSN: 1938-9116
Language: English
Date published: 08/2010
Academic Unit: Radiology; Surgery
Record Identifier: 9984051596202771

Metrics

18 Record Views

9 Times Cited - Web of Science