scholarly journals TCTAP C-200 Peripheral Arterial Disease with Chronic Total Occlusion over Right Common Iliac Artery

2016 ◽  
Vol 67 (16) ◽  
pp. S340-S342
Author(s):  
Tzu Chieh Lin ◽  
Chun-Yuan Chu ◽  
Wen-Hsien Lee ◽  
Po-Chao Hsu ◽  
Ho-Ming Su ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Iliac Artery ◽  
Chronic Total Occlusion ◽  
Common Iliac Artery ◽  
Arterial Disease ◽  
Total Occlusion ◽  
Peripheral Arterial

scholarly journals Treatment of an external iliac artery chronic total occlusion using alternate access sites

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Justin Ratcliffe ◽  
Mike Gorenchtein ◽  
Pankaj Khullar ◽  
Abel Casso Dominguez ◽  
Mohan Satish ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Chronic Total Occlusion ◽  
External Iliac Artery ◽  
Arterial Disease ◽  
Patient Comfort ◽  
Vascular Lesions ◽  
Symptom Improvement ◽  
Total Occlusion ◽  
Maximal Medical Therapy ◽  
Peripheral Arterial

Abstract Background With the advent of endovascular techniques, alternate sites such as the pedal and radial arteries can now be accessed when treating peripheral arterial disease to reduce procedural complications, shorten recovery time, and improve patient comfort. However, a paucity of literature exists on the availability of support devices that can be utilized during challenging cases. Case presentation A 70 year-old female patient presented for evaluation of severe lifestyle-limiting left-sided claudication refractory to maximal medical therapy. Angiography revealed a chronic total occlusion of the left external iliac artery, which was treated successfully by percutaneous intervention via a primary transpedal approach and with the assistance of the Outback® Elite re-entry device. The patient was discharged 2 h after the procedure and reported significant symptom improvement at follow-up. Conclusion This case highlights a newly adopted endovascular approach through an alternate access site and illustrates how the Outback® Elite device can be used as an adjunctive tool in the treatment of complex lower-extremity vascular lesions.

Efficacy of metal tip catheter for chronic total occlusion lesions in peripheral arterial disease

2011 ◽  
Vol 27 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Minoru Ihara ◽  
Tsugiyoshi Yamazaki ◽  
Masaharu Kudo ◽  
Osamu Murai ◽  
Yoshiaki Tsukamoto
Keyword(s):  
Peripheral Arterial Disease ◽  
Chronic Total Occlusion ◽  
Arterial Disease ◽  
Total Occlusion ◽  
Metal Tip ◽  
Peripheral Arterial

scholarly journals The Association of Cardio-Ankle Vascular Index and Ankle-Brachial Index in Patients with Peripheral Arterial Disease

Pulse ◽  
2021 ◽  
pp. 1-6
Author(s):  
Taichiro Hayase
Keyword(s):  
Peripheral Arterial Disease ◽  
Chronic Total Occlusion ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Artery Stenosis ◽  
Total Occlusion ◽  
Brachial Blood Pressure ◽  
Below The Knee ◽  
Peripheral Arterial ◽  
Stenotic Lesions

<b><i>Introduction:</i></b> The cardio-ankle vascular index (CAVI) is a well-known index to evaluate arterial stiffness and predict cardiovascular risk. <b><i>Methods:</i></b> We investigated whether CAVI can predict severity and extent of peripheral arterial disease. This study was a single-center, retrospective, observational study approved by the Ethics Committee of Yokohama Shintoshi Neurosurgical Hospital. A total of 96 patients (males, 63) with an abnormal ankle-brachial blood pressure index (ABI) of &#x3c;0.9 and who underwent extremity arteriography at our hospital from 2015 to 2018 were enrolled in this study. We defined that CAVI with a range of &#x3c;8.0 was normal. <b><i>Results:</i></b> Coronary angiography and extremity arteriography were performed for patients who had intermittent claudication and abnormal ABI. We divided the affected limbs into 3 categories: above-the-knee artery stenosis, above-the-knee artery chronic total occlusion, and only below-the-knee artery stenosis/occlusion groups. CAVI pseudonormalization was seen in 28, 76, and 19%, respectively. The above-the-knee artery stenosis and the only below-the-knee artery stenosis/occlusion groups had a high odds ratio of abnormalization of CAVI (3.1, 95% confidence interval [CI]: 1.39–7.22; <i>p</i> = 0.05, 4.56, 95% CI: 1.64–14.7). <b><i>Discussion/Conclusion:</i></b> In the presence of the above-the-knee artery chronic total occlusion, CAVI pseudonormalization was likely to be seen. The presence of CTO in the above-the-knee artery is one cause of pseudonormalized CAVI. In the range of ABI, in which stenotic lesions and obstructive lesions coexist, it may be possible to detect the existence of CTO by a combination of both ABI and CAVI.

A comparative study of geometry-based methods and intra-arterial pressure measurements to assess the hemodynamic significance of equivocal iliac artery stenoses

Vascular ◽  
2018 ◽  
Vol 27 (2) ◽  
pp. 119-127
Author(s):  
Stefan GH Heinen ◽  
Wouter Huberts ◽  
Daniel AF van den Heuvel ◽  
Frans N van de Vosse ◽  
Jean-Paul PM de Vries ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Iliac Artery ◽  
Visual Inspection ◽  
Arterial Disease ◽  
Lumen Diameter ◽  
Pressure Measurements ◽  
Rotational Angiography ◽  
3D Rotational Angiography ◽  
Peripheral Arterial ◽  
Diameter Reduction

Objectives To date, the ultimate decision to treat iliac artery stenoses in patients suffering from symptomatic peripheral arterial disease is based on the patient’s symptoms and on visual inspection of angiographical images. The primary aim of this study was to investigate the accuracy of geometry-based methods (i.e. visual inspection and quantitative vascular analysis (Viewforum version R7.2v1 Advanced vessel analysis, Philips Healthcare, Best, The Netherlands) of 3D rotational angiography) to identify the severity of equivocal iliac artery stenosis in peripheral arterial disease patients with intra-arterial hyperemic pressure measurements (gold standard) as a reference. Methods Twenty patients with symptomatic iliac artery stenoses were subjected to 3D rotational angiography. Intra-arterial pressure measurements under hyperemic conditions were performed across 24 visually identified iliac artery stenoses. Three experienced interventional-radiologists retrospectively estimated the lumen diameter reduction by visual inspection. Furthermore, quantitative vascular analysis was performed on the 3D rotational angiography data. Geometry-based estimates were classified into two groups: lumen diameter reduction of <50% (non-significant) and diameter reduction [Formula: see text]50% (significant), and compared to the intra-arterial hyperemic pressure gradients. A stenosis causing a pressure gradient (Δp) ≥10 mmHg was considered hemodynamically significant. Results Visual inspection and quantitative vascular analysis correctly identified hemodynamically significant stenoses in, respectively, 83% and 67% of the 24 iliac artery stenoses. Quantitative vascular analysis-based identification of hemodynamic significant stenoses (Δp ≥ 10 mmHg) could be optimized by lowering the threshold to a 42% lumen diameter reduction which improved the accuracy from 67% to 83%. Conclusions Visual inspection of 3D rotational angiography by experienced interventional-radiologists has an 83% accuracy to identify hemodynamic significant iliac artery stenoses (Δ p ≥10 mmHg). The use of quantitative vascular analysis software did not improve accuracy.

scholarly journals Dual alternate access sites for the treatment of an ostial left common iliac artery chronic total occlusion

2020 ◽  
Vol 8 ◽  
pp. 2050313X2092919
Author(s):  
Mohan Satish ◽  
Sanjum S Sethi ◽  
Sahil Parikh ◽  
Philip Green ◽  
Justin Ratcliffe
Keyword(s):  
Femoral Artery ◽  
Iliac Artery ◽  
Chronic Total Occlusion ◽  
Common Iliac Artery ◽  
Ulnar Artery ◽  
Common Femoral Artery ◽  
Peroneal Artery ◽  
True Lumen ◽  
Total Occlusion ◽  
Left Common Iliac Artery

Growing endovascular strategies with TASC D lesions in aortoiliac disease reflect increasing technical success with evidenced safety and efficacy. In cases of failed transfemoral access, revascularization of iliac chronic total occlusions has prompted the utilization of other alternate access sites (e.g. transradial and transbrachial approaches) as important options in aortoiliac TASC D lesions. We describe a case of successful revascularization of an occluded ostial left common iliac artery in an 81-year-old man using a dual ulnar and tibioperoneal approach (absent radial artery). A Controlled Antegrade and Retrograde Tracking technique was performed where a balloon was advanced from the peroneal artery into the distal cap of the chronic total occlusion in the proximal common femoral artery. Balloon inflation was performed and a glidewire from transulnar access was advanced and re-entered into the true lumen in the common femoral artery. The wire was then snared and externalized out the transpedal access site creating a continuous true lumen from the ulnar artery to the peroneal artery. To reconstruct the aortic bifurcation, kissing balloon inflations were performed from the peroneal as well as the ulnar artery approaches. A 10 mm × 59 mm balloon expandable stent was placed in the ostial left common iliac artery and a 8 mm × 60 mm self-expanding stent was placed in the left external iliac artery successfully.

Successful outside-the-stent stenting for in-stent chronic total occlusion in the common iliac artery

2012 ◽  
Vol 27 (2) ◽  
pp. 131-136 ◽  
Author(s):  
Takayuki Ishihara ◽  
Osamu Iida ◽  
Shin Okamoto ◽  
Tomoharu Dohi ◽  
Kei Sato ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Chronic Total Occlusion ◽  
Common Iliac Artery ◽  
Total Occlusion ◽  
The Common

scholarly journals Revascularization of Chronic Total Occlusion of the Infrarenal Aorta in a Patient with Triple Vessel Disease: Report of a Case Treated by Endovascular Approach

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Mahek Shah ◽  
Soumya Patnaik ◽  
Rahul Sinha ◽  
Issac Opoku-Asare ◽  
Khalid Chaudhry ◽  
...  
Keyword(s):  
Chronic Total Occlusion ◽  
Significant Coronary Artery Disease ◽  
Arterial Disease ◽  
Occlusive Disease ◽  
Infrarenal Aorta ◽  
Aortoiliac Occlusive Disease ◽  
Total Occlusion ◽  
Triple Vessel Disease ◽  
Technological Advances ◽  
Peripheral Arterial

Surgical management of advance aortoiliac occlusive disease is time-tested and a widely practiced strategy, particularly when there is significant coronary artery disease associated with aortoiliac occlusive disease. The technological advances in the field of percutaneous techniques have facilitated the use of nonsurgical endovascular alternatives for peripheral arterial disease in patients with significant comorbidities at high surgical risk, as illustrated in our case report. We report a case of chronic total occlusion of the aorta that was treated percutaneously with endovascular stenting. We also discuss the specific technique used in this procedure.

scholarly journals Diagnostic Impact of Immunonutritional Indices in Peripheral Arterial Disease Severity and Complexity

2021 ◽  
Author(s):  
Tahir Bezgin ◽  
Aziz İnan Çelik ◽  
Metin Çağdaş ◽  
Ferdi Kahraman ◽  
Kemal Mağden ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Nutritional Status ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Prognostic Nutritional Index ◽  
Arterial Disease ◽  
Total Occlusion ◽  
Modified Glasgow Prognostic Score ◽  
Study Population ◽  
Peripheral Arterial

Abstract Purpose We aimed to evaluate the relationships between the severity of peripheral arterial disease (PAD) and immune-nutritional status, as quantified by the prognostic nutritional index (PNI), controlling nutritional status score (CONUT), and modified Glasgow prognostic score (mGPS). Methods and results One hundred forty-eight patients with severe lower extremity PAD diagnosed by angiography constituted the study population. All patients had at least one severe superficial femoral arterial disease (SFA). According to the presence of a chronic total occlusion in SFA (SFA CTO), the study population was divided into two groups. Patients with SFA CTO (n: 84) had a significantly lower PNI(43.4 ± 4.8 vs. 49.1 ± 4.7, p < 0.001), worse mGPS and CONUT scores than those without SFA CTO(n:64). A comparison of the three groups, those classified according to PNI tertiles (PNI ≥ 48, n:49; 43.8 < PNI < 48, n:49; PNI < 43.8, n: 50), revealed that a lower PNI was associated with the presence of a TASC C-D lesion in the femoropopliteal segment, SFA CTO, long lesion, and long CTO. Furthermore, PNI was found to be an independent predictor of SFA CTO in the logistic regression analysis. Diagnostic performance of PNI was better than mGPS and CONUT scores in ROC curve comparison. Conclusion This is the first study demonstrating the relationship between PNI and PAD severity. Our results and the prognostic value of PNI should be validated in a larger prospective cohort.

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