Devices to treat peripheral chronic total occlusions
Hazim Al-Ameri1, Leonardo Clavijo, Ray V Matthews
1Heart Institute, Good Samaritan Hospital, Los Angeles, California Department of Cardiology, Providence Hospital, Southfield, Michigan, USA.
Journal of Interventional Cardiology
|May 9, 2012
Summary
Chronic total occlusions (CTOs) in peripheral vascular disease are challenging to treat. This review examines mechanical devices designed to improve endovascular treatment success for these difficult-to-navigate lesions.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Surgery
Background:
- Chronic total occlusions (CTOs) affect about 40% of peripheral vascular disease patients.
- CTOs present significant challenges for endovascular treatment due to difficulties in guidewire crossing and maintaining intraluminal position.
- Conventional percutaneous transluminal balloon angioplasty for CTOs has limitations, including high failure rates and risks of dissection or perforation.
Purpose of the Study:
- To review currently available mechanical devices for treating peripheral chronic total occlusions.
- To assess the potential of these devices to increase procedural success rates in endovascular interventions for CTOs.
Main Methods:
- Systematic review of literature on mechanical devices for peripheral CTOs.
- Analysis of device mechanisms and reported outcomes in endovascular procedures.
- Evaluation of challenges and advantages associated with different device types.
Main Results:
- Several mechanical devices have been developed to overcome the challenges of CTO crossing.
- These devices aim to improve guidewire navigation and reduce procedural complications.
- The review summarizes the landscape of available technologies for CTO intervention.
Conclusions:
- Mechanical devices offer promising solutions for treating complex peripheral chronic total occlusions.
- Further research and clinical adoption of these devices may enhance endovascular treatment efficacy.
- Improved device technology is crucial for managing this challenging patient subset.
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