True lumen re-entry devices facilitate subintimal angioplasty and stenting of total chronic occlusions: Initial report

Donald L. Jacobs, Raghu Motaganahalli, Daniel E. Cox, Catherine M. Wittgen, Gary J. Peterson

Research output: Contribution to journalArticle

148 Citations (Scopus)

Abstract

Objective: The acute technical failure of endovascular treatment of chronic total occlusions (CTOs) is most often due to the inability to re-enter the true lumen after occlusion is crossed in a subintimal plane. This study reports our initial experience with true lumen re-entry devices in the treatment of CTOs. Methods: Patients with treatment of CTOs were identified from our vascular registry. All patients in whom the Pioneer catheter or the Outback catheter were used were also identified from a prospectively maintained separate database of cases in which true lumen re-entry devices were used. We used procedural data from the prospective database and reviewed the medical records. Lesion character and location, access type, location of true lumen re-entry, stent usage, procedural times, and complications, were tabulated. Results: From August 2003 to December 2004, endovascular techniques were used to treat 87 CTOs in 58 iliac and 29 superficial femoral arteries. In 24 (26%), the true lumen could not be re-entered by using standard catheter and wire techniques. The true lumen was not initially re-entered in 20 (34%) of 58 of treated iliac CTOs and four (13%) of 29 of treated superficial femoral artery CTOs (73% TASC C and D lesions). Intravascular ultrasound-guided true lumen re-entry using the Pioneer catheter (21 CTOs), or fluoroscopic-guided true lumen re-entry using the Outback catheter (3 CTOs) was successful in achieving true lumen re-entry in all cases at the location desired. Total time of re-entry catheter manipulation required to achieve re-entry was

Original languageEnglish (US)
Pages (from-to)1291-1296
Number of pages6
JournalJournal of Vascular Surgery
Volume43
Issue number6
DOIs
StatePublished - Jun 2006
Externally publishedYes

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Angioplasty
Catheters
Equipment and Supplies
Femoral Artery
Databases
Endovascular Procedures
Treatment Failure
Stents
Medical Records
Blood Vessels
Registries
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

True lumen re-entry devices facilitate subintimal angioplasty and stenting of total chronic occlusions : Initial report. / Jacobs, Donald L.; Motaganahalli, Raghu; Cox, Daniel E.; Wittgen, Catherine M.; Peterson, Gary J.

In: Journal of Vascular Surgery, Vol. 43, No. 6, 06.2006, p. 1291-1296.

Research output: Contribution to journalArticle

Jacobs, Donald L. ; Motaganahalli, Raghu ; Cox, Daniel E. ; Wittgen, Catherine M. ; Peterson, Gary J. / True lumen re-entry devices facilitate subintimal angioplasty and stenting of total chronic occlusions : Initial report. In: Journal of Vascular Surgery. 2006 ; Vol. 43, No. 6. pp. 1291-1296.
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