title: Recanalization of peripheral chronic total occlusions: 'no fancy devices, just a crossing catheter'.
abstract: BACKGROUND
  Chronic total occlusions (CTOs) are challenging to treat endovascularly. Classic subintimal approach is offering only moderate success rates mainly due of the lack of dedicated crossing catheters. Purpose of this study is to assess the acute procedural success of the use of a novel hydrophilic crossing catheter in the recanalization of peripheral CTOs.
  
  
  METHODS
  This is a retrospective, single-centre study of patients with femoropopliteal CTOs. Revascularization was performed with the use of the NaviCross®- crossing catheter (Terumo Europe). Technical, procedural success and complications were assessed.
  
  
  RESULTS
  Thirty-two patients were included in the study. Mean age was 65.9 (46-85) years; Critical limb ischemia was the indication for the procedure in 26 (81%). Target vessels included 12 superficial femoral arteries, 9 popliteal, and 11 femoropopliteal segment lesions. Mean length was 85 (50-350) mm; 21(65.6%) lesions were heavily calcified. In all cases a sub-intimal approach was used; in 21 cases the procedure was performed as a day case. Technical success was achieved in 31 (96.8%) cases. Recanalization was achieved with a guidewire in 22 (71%) lesions and with the catheter alone in 9 (29%) cases. Procedural success was achieved in all lesions. No major adverse events occurred.
  
  
  CONCLUSIONS
  The use of the NaviCross®- crossing catheter showed high rate of technical and procedural success in challenging femoropopliteal CTOs without significant complications. The use of this catheter needs to be considered as the first approach for CTOs prior to the use of any other more complex re-entry device.
authors.affiliation: a Department of Radiology , Cambridge University Hospitals NHS Foundation Trust , Cambridge , UK.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cannavale
authors.affiliation: a Department of Radiology , Cambridge University Hospitals NHS Foundation Trust , Cambridge , UK.
authors.forename: Tariq
authors.initials: T
authors.lastname: Ali
authors.affiliation: b Department of Peripheral Vascular Surgery , Fuwai Hospital, National Center for Cardiovascular Diseases , Beijing , China.
authors.forename: Chen-Yang
authors.initials: CY
authors.lastname: Shen
authors.affiliation: c Department of Cardiology , Gloucestershire Hospitals NHS Foundation Trust , Cheltenham , UK.
authors.forename: George
authors.initials: G
authors.lastname: Kassimis
authors.affiliation: a Department of Radiology , Cambridge University Hospitals NHS Foundation Trust , Cambridge , UK.
authors.forename: Miltiadis
authors.initials: M
authors.lastname: Krokidis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000503:physiopathology / Q000628:therapy*; D002404:Catheterization / Q000379:methods*; D002908:Chronic Disease; D005260:Female; D005263:Femoral Artery / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Subintimal recanalization; chronic total occlusions; peripheral vascular disease