Mike Gorenchtein1, Naveed Rajper2, Philip Green2, Pankaj Khullar2, Daniel Amoruso3, Christian Franz Bulacan2, Tak Kwan2, Joseph Puma2, Justin Ratcliffe2. 1. Department of Cardiovascular Medicine, Mount Sinai Morningside Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA. mike.gorenchtein@mountsinai.org. 2. Department of Cardiovascular Medicine, Mount Sinai Morningside Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 3. Department of Cardiology, Mount Sinai Beth Israel Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Abstract
BACKGROUND: Transpedal access is increasingly utilized for the treatment of peripheral artery disease (PAD). Femoral-popliteal artery chronic total occlusions (CTOs) are some of the most difficult lesion subsets that sometimes require the use of re-entry support devices during percutaneous intervention. Limited data is available on the use of re-entry devices when treating femoral-popliteal CTOs via transpedal access. The aim of this study was to demonstrate the feasibility of using the Outback® Elite re-entry device for the treatment of femoral-popliteal CTOs via the transpedal approach in an outpatient based lab setting. METHODS: Seventeen patients presented with femoral-popliteal CTOs in which treatment required the use of the Outback® Elite re-entry device. All procedures were performed in a single outpatient based lab. Patients were followed at 1 week and 1 month post-procedure, with lower extremity arterial duplex ultrasound assessment during the 1 month follow-up. RESULTS: The average patient age was 78 years-old, with 71% being males. Most patients presented with Rutherford class IV symptoms. Procedural success was achieved in all patients with no requirement to convert to femoral artery access in any of the cases. No immediate post-procedural complications nor at any time during follow-up were observed. Ultrasonography at 1 month follow-up showed patent intervention sites and access site vessels in all patients. CONCLUSION: The use of the Outback® Elite re-entry device for the treatment of femoral-popliteal CTOs via transpedal access is a feasible option and may have potential benefits by avoiding risks associated with traditional femoral artery access.
BACKGROUND: Transpedal access is increasingly utilized for the treatment of peripheral artery disease (PAD). Femoral-popliteal artery chronic total occlusions (CTOs) are some of the most difficult lesion subsets that sometimes require the use of re-entry support devices during percutaneous intervention. Limited data is available on the use of re-entry devices when treating femoral-popliteal CTOs via transpedal access. The aim of this study was to demonstrate the feasibility of using the Outback® Elite re-entry device for the treatment of femoral-popliteal CTOs via the transpedal approach in an outpatient based lab setting. METHODS: Seventeen patients presented with femoral-popliteal CTOs in which treatment required the use of the Outback® Elite re-entry device. All procedures were performed in a single outpatient based lab. Patients were followed at 1 week and 1 month post-procedure, with lower extremity arterial duplex ultrasound assessment during the 1 month follow-up. RESULTS: The average patient age was 78 years-old, with 71% being males. Most patients presented with Rutherford class IV symptoms. Procedural success was achieved in all patients with no requirement to convert to femoral artery access in any of the cases. No immediate post-procedural complications nor at any time during follow-up were observed. Ultrasonography at 1 month follow-up showed patent intervention sites and access site vessels in all patients. CONCLUSION: The use of the Outback® Elite re-entry device for the treatment of femoral-popliteal CTOs via transpedal access is a feasible option and may have potential benefits by avoiding risks associated with traditional femoral artery access.
Authors: Mark Frederick Conrad; Richard P Cambria; David H Stone; David C Brewster; Christopher J Kwolek; Michael T Watkins; Thomas K Chung; Glenn M LaMuraglia Journal: J Vasc Surg Date: 2006-10 Impact factor: 4.268
Authors: Donald L Jacobs; Raghunandan L Motaganahalli; Daniel E Cox; Catherine M Wittgen; Gary J Peterson Journal: J Vasc Surg Date: 2006-06 Impact factor: 4.268
Authors: Ulrich Beschorner; Sebastian Sixt; Uwe Schwarzwälder; Aljoscha Rastan; Christian Mayer; Elias Noory; Roland Macharzina; Karlheinz Buergelin; Robert Bonvini; Thomas Zeller Journal: Catheter Cardiovasc Interv Date: 2009-11-15 Impact factor: 2.692