Initial Experience With the Outback Catheter for Targeted Reentry During Subintimal Angioplasty of the Infragenicular...

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Endovascular Interventions

Background:

• Chronic total occlusions (CTOs) in infragenicular arteries pose significant challenges for endovascular treatment.
• Subintimal angioplasty is a common approach, but achieving true lumen reentry can be difficult.
• Targeted reentry devices aim to improve success rates in complex CTO cases.

Purpose of the Study:

• To evaluate the Outback reentry device for targeted distal reentry during subintimal recanalization of infragenicular CTOs.
• To assess the technical success, procedural success, and reentry accuracy of the Outback device.
• To report complications associated with using the Outback device in this patient population.

Main Methods:

• Retrospective analysis of 10 patients undergoing infragenicular CTO recanalization with the Outback device over 18 months.
• The device was used for targeted reentry after subintimal crossing or when spontaneous reentry failed.
• Outcomes included technical success, overall procedure success, reentry accuracy, and complication rates.

Main Results:

• The Outback device achieved technical success in 90% (9 of 10) of cases.
• Overall procedure success was 80% (8 of 10) due to challenging calcifications.
• Reentry accuracy averaged 10.8 mm, with no major complications reported; only minor sequelae were successfully managed with stenting.

Conclusions:

• The Outback device demonstrates a high technical success rate for targeted true lumen reentry in infragenicular subintimal angioplasty.
• It is a valuable option when spontaneous reentry is not feasible or precise reentry is desired.
• The device facilitates complex endovascular interventions for peripheral artery disease.