Related Experiment Video
Updated: Jun 4, 2026
Occlusion of the Great and Small Saphenous Vein Using Copolymeric Glue Based on N-Butyl Cyanoacrylate and Methacryloxy Sulfolane
Published on: December 9, 2022
Outback catheter for femoropopliteal occlusions: immediate and long-term results
Yvonne Bausback1, Spiridon Botsios, Jacqueline Flux
1Centre of Vascular Medicine, Angiology and Vascular Surgery, Park Hospital Leipzig, Germany. ybausback@yahoo.de
Insights
The Outback catheter effectively recanalizes femoropopliteal chronic total occlusions (CTO), achieving high re-entry rates. However, high restenosis rates necessitate further investigation into managing these challenging cases.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Interventions
Background:
- Chronic total occlusions (CTO) in the femoropopliteal arteries pose significant challenges for endovascular treatment.
- Guidewire re-entry techniques often fail in complex CTOs, necessitating alternative approaches.
Purpose of the Study:
- To evaluate the technical and clinical outcomes of using the Outback re-entry catheter for subintimal recanalization of femoropopliteal CTOs.
- To assess the safety and efficacy of the Outback catheter in a retrospective, single-center study.
Main Methods:
- Retrospective analysis of 118 limbs in 113 patients undergoing femoropopliteal CTO recanalization with the Outback catheter.
- Evaluation of technical success, procedural success, complication rates, and clinical outcomes including patency rates at 12 months.
Main Results:
- Successful re-entry was achieved in 91.5% of limbs, with recanalization completed in 90.7%.
- Complications were generally minor, including access site hematoma and bleeding.
- At 12 months, primary patency was 56.7%, assisted primary patency 83.1%, and secondary patency 89.1%.
Conclusions:
- The Outback catheter is a reliable tool for recanalizing complex femoropopliteal CTOs, particularly after failed guidewire attempts.
- High restenosis rates were observed, potentially linked to the severity and extent of disease in this challenging patient cohort.
Purpose:
To report a retrospective, single-center study that evaluates technical and clinical outcomes from subintimal recanalization of femoropopliteal chronic total occlusions (CTO) facilitated by the Outback re-entry catheter.
Methods:
The Outback catheter was required to complete recanalization of femoropopliteal CTOs (mean lesion length 195 ± 91 mm) in 118 limbs of 113 patients (77 men; mean age 70 ± 10 years). In 80/118 (67.8%) limbs, treatment was performed for claudication and in the remaining 38 (32.2%) for critical limb ischemia (CLI). Technical and procedural success, clinical outcome, and cumulative patency rates in follow-up were evaluated.
Results:
Re-entry was accomplished in 108/118 limbs (91.5%) with recanalization completed in 107/118 (90.7%). Of these, only 61/107 (57%) arteries were left with a residual stenosis <30%. Complications included minor bleeding of the target vessel (5/118, 4.2%) and minor hematoma/pseudoaneurysm at the access site (6/118, 5.1%). Acute reocclusion developed in 2/118 cases (1.7%) without major complication. After 12 months, primary patency was 56.7%, assisted primary patency 83.1%, and secondary patency 89.1%. Primary patency was significantly reduced in limbs with residual stenosis. Over a median 15-month follow-up (range 2-32), 4 major and 2 minor amputations were performed in patients with CLI.
Conclusion:
The Outback catheter is a reliable tool to recanalize challenging chronic femoropopliteal occlusions after failed guidewire re-entry. Restenosis rates are high, which may be due to the severity and extent of disease in these patients, who are particularly challenging.
