Novel use of ultrasound guidance for recanalization of iliac, femoral, and popliteal arteries.
OBJECTIVE
We attempted to demonstrate the safety and feasibility of intravascular ultrasound (IVUS)-guided endluminal endovascular therapy for chronic total occlusion (CTO) of the iliac and/or femoropopliteal arteries using Treasure 12, a stiff guidewire for peripheral CTO of 0.018 in. in monodirectional approach setting.


BACKGROUND
Endovascular therapy for CTO of the iliac and femoropopliteal arteries is still technically challenging.


METHODS
Endovascular therapy was performed in 110 patients who were admitted to Hyogo College of Medicine Hospital with iliac and/or femoropopliteal artery disease from January 2006 to October 2007. We retrospectively analyzed the data of consecutive 47 patients who underwent the endovascular therapy by monodirectional approach for CTO lesions of the iliac and femoropopliteal arteries. From January 2006 to November 2006 (phase 1), standard technique was applied for the treatment of 21 lesions. From December 2006 to October 2007 (phase 2), IVUS-guided endovascular therapy was applied for the treatment of 31 lesions.


RESULTS
Clinical and lesion characteristics in phase 1 were not significantly different from those in phase 2. The overall initial technical success rate improved from 81% in phase 1 to 97% in phase 2. There were no significant differences in radiation exposure time between phase 1 and phase 2. Total volume of contrast material was significantly smaller in phase 2 than in phase 1 (P < 0.01).


CONCLUSIONS
The IVUS-guided endovascular therapy for CTO using Treasure 12 guidewire is feasible and safe, minimizes contrast material, and has a high initial technical success rate.
Kawasaki
Daizo
D
Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Tsujino
Takeshi
T
Fujii
Kenichi
K
Masutani
Motomaru
M
Ohyanagi
Mitsumasa
M
Masuyama
Tohru
T
D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D002908:Chronic Disease; D003287:Contrast Media / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011859:Radiography; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014654:Vascular Patency
D003287:Contrast Media