title: Subintimal revascularization of chronic iliac artery occlusions using a reentry-catheter.
abstract: OBJECTIVE
  To demonstrate the value of a Reentry-Catheter for true lumen access after subintimal revascularization of chronic iliac artery occlusions.
  
  
  METHODS
  Subintimal revascularization was performed in 5 patients (mean age: 67 ± 12 years; female: 3, male: 2) with total iliac artery occlusion (TASC B to D), but without gaining access to the true lumen distal to the occlusion. Subsequently, a Reentry-Catheter was used to establish reentry and a new subintimal tract. Patients were followed up after 6, 12 and 24 months for clinical re-evaluation to determine the Rutherford score and the ankle brachial index (ABI). In addition, duplex ultrasound was performed to evaluate vessel patency.
  
  
  RESULTS
  The primary technical success rate was 100 %. In all cases angioplasty was followed by stent placement to establish the subintimal tract. The mean Rutherford score decreased from 3.6 ± 0.9 to 0.33 ± 0.57 after 24 months, while the ABI increased from 0.67 ± 0.06 to 1.2 ± 0. Vessel patency was observed in all patients available for follow-up examinations.
  
  
  CONCLUSIONS
  The Reentry-Catheter reliably allowed access to the true lumen after subintimal revascularization of occluded iliac arteries. Results in this small patient cohort showed a significant reduction in the Rutherford score, increase in the ABI, and a good patency rate after two years.
authors.affiliation: Diagnostic and Interventional Radiology, Saarland University Hospital, 66421 Homburg/Saar, Germany. peterminko@yahoo.com
authors.forename: P
authors.initials: P
authors.lastname: Minko
authors.forename: M
authors.initials: M
authors.lastname: Katoh
authors.forename: A
authors.initials: A
authors.lastname: Opitz
authors.forename: S
authors.initials: S
authors.lastname: Jäger
authors.forename: A
authors.initials: A
authors.lastname: Bücker
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000295:instrumentation*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D057785:Catheters / Q000592:standards*; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015424:Reperfusion / Q000592:standards; D015607:Stents; D016896:Treatment Outcome