title: Trans-collateral angioplasty in vascular access intervention therapy for subacute occluded vessel.
abstract: We describe the first reported case of successful trans-collateral angioplasty (TCA) in vascular access intervention therapy (VAIVT) for a subacute occluded lesion in the vascular access route. TCA is a technique which has been developed in the field of endovascular therapy for peripheral arterial disease and is usually applied for a long chronic total occluded lesion with no available distal puncture site. Because such lesion characteristics suitable for being applied with TCA are not usually seen in the patients who receive VAIVT, there is little opportunity when TCA is performed in VAIVT. The present patient showed subacute occlusion in the vascular access route with well-developed collateral blood vessels. Because antegrade wiring resulted in subintimal tracking, we failed to antegradely introduce the guidewire to the vascular true lumen. Moreover, no puncture site in the venous side was anatomically available. Therefore, we adopted the strategy of TCA and successfully completed the procedure. Although we rarely encounter the situation in which TCA is necessary for VAIVT, the strategy of TCA is a promising procedure if the condition permits.
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, Nantan City - Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Higuchi
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, Nantan City - Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Nomura
authors.affiliation: Department of Nephrology, Nantan General Hospital, Nantan City - Japan.
authors.forename: Kisho
authors.initials: K
authors.lastname: Ikeda
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, Nantan City - Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kubota
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, Nantan City - Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Miyawaki
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, Nantan City - Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Urata
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, Nantan City - Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sugimoto
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, Nantan City - Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, Nantan City - Japan.
authors.forename: Natsuya
authors.initials: N
authors.lastname: Keira
authors.affiliation: Department of Cardiovascular Medicine, Nantan General Hospital, Nantan City - Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tatsumi
mesh_terms: D000368:Aged; D000792:Angiography; D000800:Angioplasty, Balloon / Q000379:methods*; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D003097:Collateral Circulation; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D012039:Regional Blood Flow; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome