1. IVUS-Guided Wiring Improves the Clinical Outcomes of Angioplasty for Long Femoropopliteal CTO Compared with the Conventional Intraluminal Approach
- Author
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Koji Isodono, Tomohiko Sakatani, Yoshinori Tsubakimoto, Daisuke Irie, Akiko Shiraga, Akiko Matsuo, Hiroshi Fujita, Tomotaka Fujimoto, Yosuke Kirii, Takeru Kasahara, Keiji Inoue, and Makoto Ariyoshi
- Subjects
Male ,Reoperation ,medicine.medical_specialty ,Duplex ultrasonography ,medicine.medical_treatment ,Lumen (anatomy) ,Arterial Occlusive Diseases ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Restenosis ,Angioplasty ,Outcome Assessment, Health Care ,Intravascular ultrasound ,Internal Medicine ,medicine ,Humans ,Popliteal Artery ,Endovascular treatment ,Ultrasonography, Interventional ,Vascular Patency ,Aged ,medicine.diagnostic_test ,business.industry ,Endovascular Procedures ,Biochemistry (medical) ,medicine.disease ,Quality Improvement ,Femoropopliteal segment ,Femoral Artery ,Chronic total occlusion ,Surgery, Computer-Assisted ,Chronic Disease ,Velocity ratio ,Female ,Original Article ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
Aims: This study aimed to assess the clinical efficacy of intravascular ultrasound (IVUS)-guided intraplaque wiring for femoropopliteal (FP) chronic total occlusion (CTO). Methods: This single-center, retrospective, observational study was performed at the Japanese Red Cross Kyoto Daini Hospital. From March 2013 to June 2017, a total of 75 consecutive patients (mean age: 75.4 ± 8.5 years; 59 males), who underwent endovascular treatment (EVT), having 82 de novo FP-CTO lesions, were enrolled in this study. Eleven of the lesions that met the exclusion criteria were excluded, and the remaining 71 lesions were divided into the IVUS-guided wiring group (n = 34) and non-IVUS-guided wiring group (n = 37). Primary patency, defined as a peak systolic velocity ratio of < 2.4 on duplex ultrasonography, and freedom from clinically driven target lesion revascularization (CD-TLR) at 12 months were the primary outcomes. Results: The mean lesion length was 21.6 ± 8.9 cm. The frequencies of primary patency and freedom from CD-TLR were significantly higher in the IVUS-guided wiring group than in the non-IVUS-guided wiring group (70.0% vs. 52.2%, p = 0.045; 83.9% vs. 62.8%, p = 0.036, respectively). The complete clinically true lumen angioplasty rate was also higher in the IVUS-guided wiring group than in the non-IVUS-guided wiring group (91.1% vs. 51.3%, p < 0.001, respectively). The clinically true and false wire passage rates were respectively 97.3% and 2.7% in the IVUS-guided wiring group. Conclusion: IVUS-guided wiring improves the clinical outcomes of EVT for FP-CTO by achieving a high clinically true lumen wire passage rate.
- Published
- 2021