title: Rendezvous technique for recanalization of long-segmental chronic total occlusion above the knee following unsuccessful standard angioplasty.
abstract: OBJECTIVE
  To assess the technical feasibility and efficacy of the rendezvous technique, a type of subintimal retrograde wiring, for the treatment of long-segmental chronic total occlusions above the knee following unsuccessful standard angioplasty.
  
  
  METHODS
  The rendezvous technique was attempted in eight limbs of eight patients with chronic total occlusions above the knee after standard angioplasty failed. The clinical symptoms and ankle-brachial index were compared before and after the procedure. At follow-up, pain relief, wound healing, limb salvage, and the presence of restenosis of the target vessels were evaluated.
  
  
  RESULTS
  The rendezvous technique was performed successfully in seven patients (87.5%) and failed in one patient (12.5%). Foot pain improved in all seven patients who underwent successful treatment, with ankle-brachial indexes improving from 0.23 ± 0.13 before to 0.71 ± 0.09 after the procedure (P < 0.001). At the end of the follow-up period, the visual analogue scale improved from 6.86 ± 1.57 to 1.57 ± 1.27 (P < 0.001). Non-healing ulcers in three patients either healed (n = 2) or improved (n = 1). No major amputation was necessary. Kaplan-Meier analyses revealed that stenosis-free rate was 83.3% at six months and 41.7% at 12 months.
  
  
  CONCLUSIONS
  The rendezvous technique is a feasible and effective treatment for chronic total occlusions above the knee when standard angioplasty fails.
authors.affiliation: Department of Interventional Oncology, Dahua Hospital, Xuhui District, Shanghai, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Cao
authors.affiliation: Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Hai-Tao
authors.initials: HT
authors.lastname: Lu
authors.affiliation: Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Wei
authors.affiliation: Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China zhaojungongradio@hotmail.com zhuyueqi@hotmail.com.
authors.forename: Jun-Gong
authors.initials: JG
authors.lastname: Zhao
authors.affiliation: Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.forename: Yue-Qi
authors.initials: YQ
authors.lastname: Zhu
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000009:adverse effects*; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000379:methods*; D055109:Ankle Brachial Index; D002908:Chronic Disease; D003251:Constriction, Pathologic; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D017211:Treatment Failure; D014654:Vascular Patency; D014945:Wound Healing
keywords: Angioplasty; chronic total occlusion; limb ischemia