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Yamada T, Kawasaki D. Direct occluded vessel puncture technique as a new access site for complex peripheral artery occlusive disease. J Cardiol Cases 2020; 22:163-165. [PMID: 33014196 DOI: 10.1016/j.jccase.2020.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/11/2020] [Accepted: 05/26/2020] [Indexed: 11/30/2022] Open
Abstract
A 77-year-old male was admitted to our hospital for severe intermittent claudication of both legs. He was diagnosed with aorto-iliac occlusions and a right femoro-popliteal artery occlusion with a diseased common femoral artery by a computed tomography angiography of the lower limb. We planned endovascular therapy for these multi-level occlusive lesions. The aorto-iliac lesion of the left side was antegradely recanalized via the left brachial artery. That of the right side was recanalized retrogradely by a direct occlusive vessel puncture (DOVP) with a dedicated 20 G needle and the Hi-Torque Command 18 ST. After stenting, his symptoms were completely relieved without revascularization of right femoro-popliteal artery, and he was discharged without any complications. The DOVP may also be used as an alternative option when there is not an appropriate approach site. <Learning objective: The appropriate selection of the access site for peripheral artery occlusive disease (PAOD) is one of the most important factors to obtain a successful guidewire recanalization. We occasionally encounter multi-level PAOD without an appropriate access site. The direct occluded vessel puncture should be considered as an alternative option.>.
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Affiliation(s)
| | - Daizo Kawasaki
- Division of Cardiology, Morinomiya Hospital, Osaka, Japan
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2
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Chiam PT. Endovascular recanalisation of chronic aortoiliac occlusions - will this become the initial treatment of choice? ASIAINTERVENTION 2019; 5:107-109. [PMID: 36483526 PMCID: PMC9706723 DOI: 10.4244/aijv5i2a17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Paul T.L. Chiam
- Mount Elizabeth Hospital, 3 Mount Elizabeth, #08-06, Singapore 228510
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3
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Kato T, Zen K, Kawarada O, Hozawa K, Anzai H, Nakamura H, Funatsu A, Kawasaki D, Tsubakimoto Y, Higashimori A, Kozuki A, Matoba S. Clinical outcomes of endovascular treatment for chronic aortic occlusion: a retrospective multicentre registry: EVT for chronic aortic occlusion. ASIAINTERVENTION 2019; 5:121-127. [PMID: 34912975 DOI: 10.4244/aij-d-18-00050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 04/11/2019] [Indexed: 12/12/2022]
Abstract
AIMS The aim of this study was to evaluate the clinical outcomes of endovascular treatment (EVT) for chronic aortic occlusion (CAO) using multicentre registry data. METHODS AND RESULTS From April 2003 to December 2015, data on 73 consecutive patients (55 men and 18 women; aged 70.7±12.2 years) who underwent EVT for CAO were collected retrospectively from 15 centres in Japan. The primary endpoint was the primary patency at 12 months after EVT. Secondary endpoints were procedural success and periprocedural complication rates. We analysed 67 patients who underwent complete endovascular revascularisation after 2007. Initial procedural success was achieved in 63 cases (94.0%). Complications occurred in three patients (4.5%) (stroke, n=1; distal embolism, n=1; access-site haematoma requiring blood transfusion, n=1). In patients after successful EVT (n=63), the primary and secondary patency rates at 12 months were 90.7% and 97.7%, respectively. During a mean follow-up period of 17.8 months, restenosis/re-occlusion was observed in eight patients (12.7%). CONCLUSIONS EVT for CAO could be performed safely with a high procedural success rate. The short-term clinical outcome was acceptable despite lesion complexity.
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Affiliation(s)
- Taku Kato
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Kan Zen
- Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Osami Kawarada
- Department of Cardiovascular Medicine, Ikuwakai Memorial Hospital, Osaka, Japan
| | - Koji Hozawa
- Department of Cardiology, Interventional Cardiology Unit, New Tokyo Hospital, Matsudo, Japan
| | - Hitoshi Anzai
- Department of Cardiology, Ota Memorial Hospital, Ota, Japan
| | - Hiroaki Nakamura
- Department of Cardiology, Kakogawa Central City Hospital, Kakogawa, Japan
| | | | - Daizo Kawasaki
- Cardiovascular Division, Department of Internal Medicine, Morinomiya Hospital, Osaka, Japan
| | | | | | - Amane Kozuki
- Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Satoaki Matoba
- Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Groot Jebbink E, Holewijn S, Versluis M, Grimme F, Hinnen JW, Sixt S, Angle JF, Dorigo W, Reijnen MMPJ. Meta-analysis of Individual Patient Data After Kissing Stent Treatment for Aortoiliac Occlusive Disease. J Endovasc Ther 2018; 26:31-40. [PMID: 30499352 PMCID: PMC6330696 DOI: 10.1177/1526602818810535] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate short- and long-term technical and clinical outcomes after kissing stent treatment of aortoiliac occlusive disease (AIOD) based on an individual participant data (IPD) meta-analysis. MATERIALS AND METHODS A search of the Scopus database identified 156 articles on KS treatment of AIOD; of these 22 met the inclusion criteria. Authors of 19 articles with contact information were approached to join an IPD consortium. Eight author groups responded and 5 provided anonymized data for merging into an IPD database. The number of included procedures was equal before and after 2005. The primary study outcome was the cumulative patency at 24 months. Secondary outcomes were patency at up to 60 months, complications, and changes in Rutherford category and ankle-brachial index. The predictive value of stent protrusion length, pre-/postdilation, stent type, and patient demographics on primary patency were examined with Cox proportional hazard modeling; outcomes are reported as the hazard ratio (HR). The Kaplan-Meier method was employed to estimate patency rates. RESULTS In total, 605 (40.9%) of 1480 patients presented in the literature were included in the IPD analysis. The indication for intervention was intermittent claudication in 84.2% and critical limb ischemia in 15.8%. Lesions were classified as TransAtlantic Inter-Society Consensus (TASC) A or B in 52.8% and TASC C and D in 47.2%. The overall primary patency estimate was 81% at 24 months. Primary patency significantly increased after 2005 (p=0.005). Cox regression analysis revealed only age as a significant predictor of sustained primary patency (HR 0.60, p<0.005). Any previous endovascular intervention (HR 2.52, p=0.02) was the main predictor for loss of secondary patency; history of cardiovascular disease (HR 0.27, p=0.04) was the main predictor of sustained secondary patency. CONCLUSION The kissing stent technique has a good safety profile and acceptable patency rates up to 2 years, even in TASC C and D lesions, supporting an endovascular-first approach for AIOD.
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Affiliation(s)
- Erik Groot Jebbink
- 1 Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands.,2 Multi-Modality Medical Imaging Group, Technical Medical Centre, University of Twente, the Netherlands.,3 Physics of Fluids Group, Technical Medical Centre, University of Twente, Enschede, the Netherlands
| | - Suzanne Holewijn
- 1 Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands
| | - Michel Versluis
- 2 Multi-Modality Medical Imaging Group, Technical Medical Centre, University of Twente, the Netherlands.,3 Physics of Fluids Group, Technical Medical Centre, University of Twente, Enschede, the Netherlands
| | - Frederike Grimme
- 1 Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands
| | - Jan Willem Hinnen
- 4 Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
| | - Sebastian Sixt
- 5 Cardiovascular Center, Hamburg University, Hamburg, Germany
| | - John F Angle
- 6 Department of Radiology and Medical Imaging, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Walter Dorigo
- 7 Department of Cardiothoracic and Vascular Surgery, Careggi University Teaching Hospital, University of Florence School of Medicine, Florence, Italy
| | - Michel M P J Reijnen
- 1 Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands.,2 Multi-Modality Medical Imaging Group, Technical Medical Centre, University of Twente, the Netherlands
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Miyawaki D, Nomura T, Sakaue Y, Ueno D, Hori Y, Yoshioka K, Kubota H, Kikai M, Keira N, Tatsumi T. A rare manifestation of severe critical limb ischemia caused by solitary aorto-iliac occlusive disease. Oxf Med Case Reports 2018; 2018:omy005. [PMID: 29686880 PMCID: PMC5905458 DOI: 10.1093/omcr/omy005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 12/21/2017] [Accepted: 01/17/2018] [Indexed: 11/12/2022] Open
Abstract
Currently, there are more opportunities to treat patients complicated with critical limb ischemia (CLI), which is a very dismal medical condition associated with a high risk of major amputation, disability and death. Because CLI is usually caused by multi-level occlusive atherosclerotic disease, the condition of CLI induced by aorto-iliac occlusive disease (AIOD) alone is thought to be a rare pathological entity. We encountered a patient with severe CLI caused by solitary AIOD. Three vascular access routes were established and stiff guidewires retrogradely passed the occluded arteries on both sides. We deployed two self-expandable bare metal stents and complete revascularization led to wound healing. Recent improvements of catheter devices and procedural techniques related to endovascular treatment (EVT) have enabled us to safely recanalize complex vascular lesions of the lower extremities. Therefore, an EVT strategy is one of the favorable treatment options for CLI patients who are contraindicated for surgical treatments.
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Affiliation(s)
- Daisuke Miyawaki
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, Kyoto, Japan
| | - Tetsuya Nomura
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, Kyoto, Japan
| | - Yu Sakaue
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, Kyoto, Japan
| | - Daisuke Ueno
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, Kyoto, Japan
| | - Yusuke Hori
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, Kyoto, Japan
| | - Kenichi Yoshioka
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, Kyoto, Japan
| | - Hiroshi Kubota
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, Kyoto, Japan
| | - Masakazu Kikai
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, Kyoto, Japan
| | - Natsuya Keira
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, Kyoto, Japan
| | - Tetsuya Tatsumi
- Department of Cardiovascular Medicine, Kyoto Chubu Medical Center, Kyoto, Japan
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6
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Groot Jebbink E, Holewijn S, Slump CH, Lardenoije JW, Reijnen MM. Systematic Review of Results of Kissing Stents in the Treatment of Aortoiliac Occlusive Disease. Ann Vasc Surg 2017; 42:328-336. [DOI: 10.1016/j.avsg.2017.01.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 11/07/2016] [Accepted: 01/23/2017] [Indexed: 12/20/2022]
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7
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Ogoyama Y, Ogata N, Toriumi S, Kario K. Successful hybrid treatment with endovascular aorto-iliac revascularization and coronary bypass surgery in a patient with an advanced complex polyvascular disease. J Cardiol Cases 2017; 15:201-205. [PMID: 30279780 DOI: 10.1016/j.jccase.2017.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 02/06/2017] [Accepted: 02/22/2017] [Indexed: 11/16/2022] Open
Abstract
A 72-year-old Japanese man was admitted to our hospital for effort chest pain and bilateral claudication. He was diagnosed as having severe ischemic heart disease and chronic bilateral aorto-iliac occlusions (Leriche syndrome) by a diagnostic angiography. Manifest collaterals via bilateral internal thoracic arteries (ITA) supplied sufficient blood flow for his lower limbs. We planned a two-stage operation for both the severe coronary artery disease and peripheral artery occlusive disease. He first underwent endovascular therapy (EVT) for bilateral aorto-iliac occlusion. One month later he underwent coronary artery bypass grafting (CABG) that was carried out for three coronary arteries with bilateral ITAs, also known as the internal thoracic artery, and the gastroepiploic artery. His chest symptoms and claudication were completely relieved and he was discharged uneventfully. We hereby suggest that EVT can be a safe, effective, and minimally invasive treatment to enable the patient to undergo CABG with all arterial grafts. <Learning objective: Patients with polyvascular disease are at a high risk for major vascular events. The priority among the revascularizations should be considered based on the less-invasiveness and better long-term patency. Hybrid treatment of EVT and CABG could be one of the choices among such patients.>.
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Affiliation(s)
- Yukako Ogoyama
- Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Nobuhiko Ogata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Shinichi Toriumi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
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Nomura A, Nagashima M, Tomoi Y, Tosaka A, Soga Y. Successful endovascular treatment for high take off aorto-iliac occlusive disease. Intern Med 2015; 54:921-4. [PMID: 25876573 DOI: 10.2169/internalmedicine.54.2920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 73-year-old man with a history of intermittent claudication for the previous six years visited our hospital. His ankle-brachial index (ABI) was very low on both sides, and computed tomography (CT) indicated bilateral aorto-iliac occlusive disease (AIOD). As he refused to undergo open surgery, endovascular treatment (EVT) was administered. After the first and second EVT sessions, the intermittent claudication improved completely. In addition, the ABI normalized (right: 1.01, left: 0.99), and CT demonstrated full expansion of the stents. His post-EVT course was uneventful for 18 months. The use of EVT to treat AIOD is technically feasible and may serve as a potential treatment option for patients with an inoperable condition.
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Affiliation(s)
- Akihiro Nomura
- Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Japan
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9
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Contrast stainings outside the stents of the superficial femoral artery after polymer-free drug-eluting peripheral stents implantation. Cardiovasc Interv Ther 2014; 30:293-8. [DOI: 10.1007/s12928-014-0290-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 07/25/2014] [Indexed: 11/25/2022]
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Mujtaba M, Chhabra L, Abdulbaki AM, Sadiq I. Balloon angioplasty with secondary stenting for chronically occluded abdominal aorta in a high-risk patient. BMJ Case Rep 2014; 2014:bcr-2014-204959. [PMID: 25056303 DOI: 10.1136/bcr-2014-204959] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Mohmmadtokir Mujtaba
- Department of Cardiology, Hartford Hospital, University of Connecticut School of Medicine, Hartford, Connecticut, USA
| | - Lovely Chhabra
- Hartford Hospital, University of Connecticut School of Medicine, Hartford, Connecticut, USA
| | | | - Immad Sadiq
- Department of Cardiology, Hartford Hospital, University of Connecticut School of Medicine, Hartford, Connecticut, USA
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Angioscopically apparent large thrombus and uncovered stent struts 6 months after late stent thrombosis of a paclitaxel-coated nitinol drug-eluting stent implanted in the superficial femoral artery. Cardiovasc Interv Ther 2013; 29:82-5. [DOI: 10.1007/s12928-013-0197-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 07/01/2013] [Indexed: 10/26/2022]
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12
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Efficacy of statin treatment after endovascular therapy for isolated below-the-knee disease in patients with critical limb ischemia. Cardiovasc Interv Ther 2013; 28:374-82. [DOI: 10.1007/s12928-013-0188-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 05/23/2013] [Indexed: 11/25/2022]
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13
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Stent implantation for chronic total occlusion in the iliac artery using intravascular ultrasound-guided carbon dioxide angiography without iodinated contrast medium. Cardiovasc Interv Ther 2013; 28:415-8. [DOI: 10.1007/s12928-013-0183-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 04/23/2013] [Indexed: 10/26/2022]
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