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Sharafuddin MJ, Hoballah JJ, Kresowik TF, Nicholson RM, Sharp WJ. Impact of Aggressive Endovascular Recanalization Techniques on Success Rate in Chronic Total Arterial Occlusions (CTOs). Vasc Endovascular Surg 2010; 44:460-7. [DOI: 10.1177/1538574410370375] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Melhem J. Sharafuddin
- Department of Surgery, The University of Iowa Roy and Lucille Carver College of Medicine, Iowa City, IA, USA, , Department of Radiology, The University of Iowa Roy and Lucille Carver College of Medicine, Iowa City, IA, USA
| | - Jamal J. Hoballah
- Department of Surgery, The University of Iowa Roy and Lucille Carver College of Medicine, Iowa City, IA, USA
| | - Timothy F. Kresowik
- Department of Surgery, The University of Iowa Roy and Lucille Carver College of Medicine, Iowa City, IA, USA
| | - Rachael M. Nicholson
- Department of Surgery, The University of Iowa Roy and Lucille Carver College of Medicine, Iowa City, IA, USA
| | - William J. Sharp
- Department of Surgery, The University of Iowa Roy and Lucille Carver College of Medicine, Iowa City, IA, USA
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