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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
PubMed

Insights

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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