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Recanalization of total arterial occlusions with the Kensey dynamic angioplasty catheter
M H Wholey1, J A Smith, P Godlewski
1Department of Radiological Sciences and Diagnostic Imaging, Shadyside Hospital, Pittsburgh, PA 15232.
Insights
The Kensey dynamic angioplasty catheter offers a new approach for peripheral arterial occlusions. While some patients achieved successful recanalization and limb salvage, others experienced reocclusion or complications requiring amputation.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Medical Devices
Background:
- Peripheral arterial occlusions pose significant challenges, particularly in patients with high cardiovascular risk.
- Conventional bypass surgery may not be suitable for all patients with complex arterial blockages.
Purpose of the Study:
- To evaluate the safety and efficacy of the Kensey dynamic angioplasty catheter for recanalizing peripheral arterial occlusions.
- To assess the outcomes of using this novel device in patients ineligible for traditional surgical interventions.
Main Methods:
- A study involving twelve patients with segmental peripheral arterial occlusions.
- Treatment administered via both open surgery (four patients) and percutaneous transluminal angioplasty (eight patients).
Main Results:
- Successful recanalization and limb salvage were achieved in some patients treated surgically.
- Percutaneous treatment showed initial success in seven patients, but four experienced early reocclusion necessitating amputation.
- One patient undergoing percutaneous treatment suffered distal embolization and required amputation.
- Long-term follow-up confirmed patency in three patients with initially successful percutaneous recanalizations.
Conclusions:
- The Kensey dynamic angioplasty catheter demonstrates potential for recanalizing peripheral arterial occlusions, with variable outcomes.
- Careful patient selection and procedural technique are crucial to optimize results and minimize complications like reocclusion and embolization.
Abstract:
The Kensey dynamic angioplasty catheter is a new device for recanalization of peripheral arterial occlusions. Twelve patients with segmental occlusions who were not considered candidates for conventional bypass surgery because of cardiovascular risk factors were studied. Four of the patients were treated in the operating room. Two had excellent primary results in limb salvage situations, and recanalization of an occluded femoropopliteal bypass graft was successful in another. Bilateral iliac recanalizations in the fourth patient were locally successful but did not prevent the patient's death from advanced ischemic disease. Eight patients were treated percutaneously. Initial recanalization was successful in seven. Four had early reocclusions and required amputation below the knee. One suffered distal embolization after recanalization of a 6-cm popliteal segment and underwent above-the-knee amputation. Long-term follow-up (7-18 months) in the other three patients with successful primary recanalizations has confirmed patency of the recanalized segments.