title: Recanalization of chronic occlusions of the superficial femoral artery using the Outback re-entry catheter: a single centre experience.
abstract: OBJECTIVE
  To report our experience with a catheter system (The Outback catheter) designed to allow fluoroscopically controlled re-entry after subintimal guide wire passage during recanalization of chronically occluded femoro-popliteal arteries.
  
  
  METHODS
  Between March 2007 and August 2008, 65 legs in 61 patients (60% male, mean age 73 (49-98 years) with chronic occlusion of the SFA and proximal popliteal artery were treated. Clinical presentation was severe intermittent claudication (Rutherford category 3, 59%), rest pain (Rutherford category 4, 16%), and minor ulcerations (Rutherford category 5, 25%). In all cases, the true lumen could not be entered by using standard antegrade catheter and guide wire techniques.
  
  
  RESULTS
  Median lesion length was 200 +/- 102 mm. Recanalization of the arterial occlusion was successful in 57 of 65 treated lesions (88%). One patient died of myocardial infarction after delayed femoral bleeding possibly due to extensive recanalization attempts. There were no further procedure-related complications.
  
  
  CONCLUSIONS
  Use of the Outback re-entry catheter system is a valuable option for interventional therapy of chronically occluded femoro-popliteal arteries following failed standard antegrade recanalization attempt.
authors.affiliation: Abteilung Angiologie, Herz-Zentrum Bad Krozingen, Germany. ulrich.beschorner@herzzentrum.de
authors.forename: Ulrich
authors.initials: U
authors.lastname: Beschorner
authors.forename: Sebastian
authors.initials: S
authors.lastname: Sixt
authors.forename: Uwe
authors.initials: U
authors.lastname: Schwarzwälder
authors.forename: Aljoscha
authors.initials: A
authors.lastname: Rastan
authors.forename: Christian
authors.initials: C
authors.lastname: Mayer
authors.forename: Elias
authors.initials: E
authors.lastname: Noory
authors.forename: Roland
authors.initials: R
authors.lastname: Macharzina
authors.forename: Karlheinz
authors.initials: K
authors.lastname: Buergelin
authors.forename: Robert
authors.initials: R
authors.lastname: Bonvini
authors.forename: Thomas
authors.initials: T
authors.lastname: Zeller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D002908:Chronic Disease; D003251:Constriction, Pathologic; D004867:Equipment Design; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology / Q000628:therapy; D007871:Leg Ulcer / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D011150:Popliteal Artery / Q000000981:diagnostic imaging; D015641:Radiography, Interventional; D012189:Retrospective Studies; D016896:Treatment Outcome