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Published on: February 5, 2011
Endovascular sharp recanalization for calcified femoropopliteal artery occlusion
Hsuan-Li Huang1, Hsin-Hua Chou1, Tien-Yu Wu1
1Section of Cardiology, Department of Medicine, Buddhist Tzu Chi General Hospital, Taipei Branch, 289 Jiang Kuo Road, Xindian City, Taipei 23142, Taiwan.
Insights
This study presents a novel technique for treating challenging peripheral chronic total occlusions (CTOs) using a readily available guidewire. This method offers a cost-effective alternative when advanced devices are inaccessible, though it carries a risk of distal atheroembolism.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Medical Devices
Background:
- Peripheral chronic total occlusions (CTOs) present significant challenges in endovascular interventions.
- Existing techniques and devices for CTO crossing are often expensive and not universally accessible.
- There is a need for cost-effective and readily available methods to improve CTO recanalization success rates.
Purpose of the Study:
- To describe a novel, cost-effective technique for crossing calcified peripheral CTOs.
- To evaluate the feasibility of using the stiff end of a Terumo glidewire for recanalization.
- To report the outcomes and potential risks associated with this sharp recanalization method.
Main Methods:
- The study involved two cases of peripheral CTO recanalization.
- The stiff end of a Terumo glidewire was utilized to penetrate and cross the occlusions.
- This technique was employed when conventional methods failed and advanced devices were unavailable.
Main Results:
- Successful recanalization of peripheral CTOs was achieved in both reported cases using the glidewire technique.
- The method proved effective for crossing calcified lesions.
- A potential risk of distal atheroembolism was noted as a complication.
Conclusions:
- Sharp recanalization with the stiff end of a Terumo glidewire is a viable technique for peripheral CTOs.
- This approach offers a practical solution for calcified CTOs when advanced, costly devices are not accessible.
- Clinicians must be aware of and manage the associated risk of distal atheroembolism.
Abstract:
Endovascular intervention of peripheral chronic total occlusion (CTO) is technically challenging and time consuming. Various techniques and devices are used to facilitate lesion crossing and improve the success rate of the procedure. However, these new devices are quite expensive and not readily available. We report 2 cases of peripheral CTO wherein the occlusions were successfully crossed by using stiff end of Terumo glidewire. This sharp recanalization may be a useful technique for the recanalization of calcified peripheral CTOs when conventional techniques fail and new devices are not readily available, but it is accompanied by the risk of distal atheroembolism.
