Target Balloon-Assisted Antegrade and Retrograde Use of Re-Entry Catheters in Complex Chronic Total Occlusions

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Endovascular Interventions

Background:

• Retrograde recanalization is increasingly used for complex arterial occlusive disease.
• Re-entry devices are established adjuncts for antegrade recanalizations.

Purpose of the Study:

• To evaluate the efficacy and safety of target balloon-assisted antegrade and retrograde recanalizations using re-entry devices.
• To assess outcomes in challenging chronic total occlusions where conventional methods failed.

Main Methods:

• Retrospective multicenter registry of 36 patients undergoing target balloon-assisted re-entry.
• Inclusion criteria: antegrade/retrograde use of Outback/GoBack re-entry catheter with a balloon target for wire passage after failed conventional attempts.
• Outcomes assessed: technical success, safety (complications), and 12-month clinical outcomes (amputation-free survival, target lesion revascularization).

Main Results:

• Technical success was achieved in 34 (94%) patients.
• The procedure was performed in patients with claudication and chronic limb-threatening ischemia.
• 12-month amputation-free survival was 87.8%, and freedom from target lesion revascularization was 86.6%.

Conclusions:

• Target balloon-assisted re-entry devices are an effective and safe endovascular adjunct.
• This technique is beneficial when conventional antegrade and retrograde recanalization attempts for chronic total occlusions have failed.