title: OUTBACK catheter for treatment of superficial femoral and iliac artery chronic total occlusion: Experience from two centers.
abstract: OBJECTIVE
  The OUTBACK(®) catheter is a reentry device that enables reentry into a vessel lumen from the subintimal space during subintimal angioplasty. It is reserved for cases where reentry has not been possible using conventional wire and catheter techniques. We report a two-center experience in recanalization of the chronic total occlusions of the common iliac (CIA) and the superficial femoral artery (SFA) using the OUTBACK(®) catheter in cases where other techniques were unsuccessful.
  
  
  METHODS
  All cases where recanalization was performed using the OUTBACK(®) reentry catheter between January 2010 to January 2015 were retrospectively identified and included in this study. 21 patients were identified. The indication for intervention in these cases included claudication and critical leg ischemia. In all cases, conventional recanalization could not be successfully achieved.
  
  
  RESULTS
  The OUTBACK(®) catheter was used to recanalize 10 SFA occlusion and 9 CIA occlusions. In 19 patients (90%), reentry into true arterial lumen was successfully achieved. 17 patients had their recanalization through the transfemoral approach whereas 2 patients had a transpopliteal artery approach. In 2 patients, reentry into the true lumen could not be achieved using the OUTBACK(®) catheter due to patient's intolerability for the procedure and severe atherosclerotic calcified plaques. There was 100% patency of the vessel intervened on Duplex ultrasound at 24 months of follow up. 16 patients (84%) remained asymptomatic and 2 patients (10.5%) reported worsening of their symptoms due to the development of new lesions within the arterial system.
  
  
  CONCLUSIONS
  The OUTBACK(®) catheter is an effective and safe technique for reentry into the vessel lumen when conventional techniques fail.
authors.affiliation: Department of Radiology, University Hospital of Leicester NHS Trust, Leicester, UK; Department of Radiology, King's College Hospital NHS Trust, London, UK.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Husainy
authors.affiliation: Department of Radiology, Kurnool Medical College, Kurnool, Andhra Pradesh, India.
authors.forename: Balla
authors.initials: B
authors.lastname: Suresh
authors.affiliation: Department of Radiology, King's College Hospital NHS Trust, London, UK.
authors.forename: Cheng
authors.initials: C
authors.lastname: Fang
authors.affiliation: Department of Radiology, King's College Hospital NHS Trust, London, UK.
authors.forename: Thoraya
authors.initials: T
authors.lastname: Ammar
authors.affiliation: Department of Radiology, University Hospital of Leicester NHS Trust, Leicester, UK; Department of Radiology, Lincoln County Hospital, Lincoln, UK.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Botchu
authors.affiliation: Department of Radiology, Lincoln County Hospital, Lincoln, UK.
authors.forename: V
authors.initials: V
authors.lastname: Thava
keywords: Chronic total occlusion; OUTBACK® catheter; common iliac artery; reentry device; superficial femoral artery