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Treatment of Chronic Total Occlusions Using the Avinger Ocelot Crossing Catheter
1Vascular and Interventional Professionals, Hinsdale, Illinois.
Insights
Peripheral arterial disease (PAD) and chronic total occlusions (CTOs) are increasing. The Ocelot catheter with optical coherence tomography offers direct visualization for improved CTO crossing in PAD treatment.
Area of Science:
- Vascular medicine and interventional cardiology.
- Medical device technology and innovation.
Background:
- Peripheral arterial disease (PAD) prevalence is rising, particularly among aging populations.
- Chronic total occlusions (CTOs) in infrainguinal arteries present significant treatment challenges for endovascular specialists.
- Existing CTO crossing techniques have limitations, necessitating novel approaches.
Purpose of the Study:
- To review the Avinger Ocelot catheter, a new technology for crossing infrainguinal CTOs.
- To present the results of the multicenter CONNECT II trial evaluating the Ocelot catheter.
- To discuss the advantages of direct visualization during endovascular CTO crossing.
Main Methods:
- Review of the Avinger Ocelot catheter's optical coherence tomography (OCT) imaging technology.
- Analysis of data from the multicenter CONNECT II trial.
- Discussion of endovascular techniques for CTO crossing.
Main Results:
- The Ocelot catheter utilizes integrated OCT for real-time luminal visualization during crossing.
- The CONNECT II trial assessed the safety and efficacy of the Ocelot catheter in treating infrainguinal CTOs.
- Direct visualization may enhance procedural success rates and reduce complications.
Conclusions:
- The Avinger Ocelot catheter represents a significant advancement in endovascular CTO crossing technology.
- Direct visualization via OCT imaging offers potential benefits for treating complex PAD.
- Further evaluation of this technology in larger trials is warranted.
Abstract:
Peripheral arterial disease is becoming more prevalent as the population ages. In addition, the severity of the disease seems to be progressing from simple narrowing of vessels to chronic total occlusions (CTOs). Treatment of CTOs of the infrainguinal peripheral arteries remains a challenge even for experienced endovascular specialists. Many crossing techniques have been described ranging from standard guidewire and catheter-based techniques including subintimal recanalization to specialized CTO crossing devices. One of the newest technologies, the Avinger Ocelot catheter (Avinger, Inc., Redwood City, CA), employs optical coherence tomography imaging on the tip of a rotating crossing catheter to allow visual confirmation of luminal passage. This article will review this new technology for crossing CTOs, review the results of the multicenter CONNECT II trial, and discuss the potential benefits of direct visualization while crossing occlusions.
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