title: Initial and Long-Term Results of a Microcatheter-Based Retrograde Approach for the Endovascular Treatment of Chronic Total Occlusion in Iliac or Femoropopliteal Arteries.
abstract: BACKGROUND
  Initial and long-term outcomes of the retrograde endovascular approach using a microcatheter for the treatment of chronic total occlusion (CTO) in the iliac or femoropopliteal (FP) arteries have not been fully elucidated.
  
  
  METHODS
  From 2012 to 2014, 20 consecutive patients (21 limbs) underwent endovascular therapy (EVT) for CTO in the iliac or FP arteries using the microcatheter-based retrograde approach. An analysis of the initial and long-term outcomes was conducted.
  
  
  RESULTS
  All procedures were successful. The mean follow-up duration was 27.4 ± 11.3 months. The mean patient age was 75.8 ± 9.1 years. Eighteen (85.7%) target lesions were located in the superficial femoral artery, 1 (4.8%) in the popliteal artery, and 2 (9.5%) in the iliac artery. All lesions were de novo. The mean occlusion length was 183.3 ± 95.4 mm. A stent was used in 19 (94.5%) lesions and balloon angioplasty was performed for 2 (5.5%) lesions. Retrograde puncture site complication (hematoma in popliteal artery) was reported in 1 (4.8%) patient. Postprocedure primary patency rates at 1, 2, and 3 years were 89.5%, 72.0%, and 41.2%, respectively, and the secondary patency rates at the corresponding time points were 100%, 77.2%, and 48.6%, respectively.
  
  
  CONCLUSIONS
  Initial and long-term outcomes of EVT for CTO in iliac and FP arteries using the microcatheter-based retrograde approach are promising.
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan. Electronic address: mjunya2318@gmail.com.
authors.forename: Junya
authors.initials: J
authors.lastname: Matsumi
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Takuma
authors.initials: T
authors.lastname: Takada
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Moriyama
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Ochiai
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Tobita
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Shishido
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sugitatsu
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Mizuno
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Futoshi
authors.initials: F
authors.lastname: Yamanaka
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Murakami
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Saeko
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Akasaka
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D000800:Angioplasty, Balloon / Q000295:instrumentation; D002908:Chronic Disease; D003251:Constriction, Pathologic; D018572:Disease-Free Survival; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008904:Miniaturization; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D011677:Punctures; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D062666:Vascular Access Devices; D014654:Vascular Patency