Author + information
- Hideyuki Takimura1,
- Toshiya Muramatsu1,
- Reiko Tsukahara1,
- Masatsugu Nakano1,
- Satoshi Nishio1,
- Yukako Takimura1,
- Takayuki Yabe1,
- Mami Kawano1 and
- Tasuku Hata1
The success rate of endovascular therapy (EVT) for long chronic total occlusion (CTO) of femoro-popliteal (FP) arteries has improved because of devices development. However, patency rate after EVT has not been improved remarkably. The current study demonstrated that minimum stent area (MSA) were independent predictors for restenosis. The under expansion after self-expanded stents deployment was a problem. We had experienced under expansion in subintimal approach for EVT. Our aim was to investigate the usefulness of the novel Ultrasonography (US) guided Central Wiring Technique (CWT) in EVT for long F-P CTO lesions.
Between January 2015 and May 2016, we performed 53 cases of long F-P CTO lesions with CWT, lesion length was more than 150mm. We used 8 MHz linear transducer (Aprio 500 premier, TOSHIBA, Japan) which was set as our original preset for EVT. We performed US guided wiring with our original method. Operator controlled the guidewire as penetrated the center of CTO lesions. We assessed the procedure results, intravascular ultrasound (IVUS) findings and patency rate.
Mean age was 73.8±9.4 y.o. and female was 14 cases (26.4%). Technical success rate was 100%. All cases were only antegrade approach. There was no cases which was needed retrograde approach. Dose of radiation was 275.0 ± 379.8 mGy. Dose of contrast media was 87.3±100.5ml. Mean stent diameter was 6.5±0.7mm, length was 157.5±102.3mm. Primary patency at one year was 90.6%. In IVUS findings, rate of all true lumen tracking was 50 cases (94.3%). There was a negative correlation between the central rate of guidewire position (diameter from central to guidewire / vessel radius ×100) and MSA.
The US guided CWT with our original method was less invasive treatment and improved primary patency in EVT for long FP CTO lesions.
ENDOVASCULAR: Peripheral Vascular Disease and Intervention