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Novel use of ultrasound guidance for recanalization of iliac, femoral, and popliteal arteries.

Kawasaki D, Tsujino T, Fujii K, Masutani M, Ohyanagi M, Masuyama T

Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.

OBJECTIVES: We attempted to demonstrate the safety and feasibility of intravascular ultrasound (IVUS)-guided endluminal endovascular therapy for chronic total occlusion (CTO) of the iliac and/or femoropopliteal arteries using Treasure 12, a stiff guidewire for peripheral CTO of 0.018 in. in monodirectional approach setting. BACKGROUND: Endovascular therapy for CTO of the iliac and femoropopliteal arteries is still technically challenging. METHODS: Endovascular therapy was performed in 110 patients who were admitted to Hyogo College of Medicine Hospital with iliac and/or femoropopliteal artery disease from January 2006 to October 2007. We retrospectively analyzed the data of consecutive 47 patients who underwent the endovascular therapy by monodirectional approach for CTO lesions of the iliac and femoropopliteal arteries. From January 2006 to November 2006 (phase 1), standard technique was applied for the treatment of 21 lesions. From December 2006 to October 2007 (phase 2), IVUS-guided endovascular therapy was applied for the treatment of 31 lesions. RESULTS: Clinical and lesion characteristics in phase 1 were not significantly different from those in phase 2. The overall initial technical success rate improved from 81% in phase 1 to 97% in phase 2. There were no significant differences in radiation exposure time between phase 1 and phase 2. Total volume of contrast material was significantly smaller in phase 2 than in phase 1 (P < 0.01). CONCLUSIONS: The IVUS-guided endovascular therapy for CTO using Treasure 12 guidewire is feasible and safe, minimizes contrast material, and has a high initial technical success rate.

Published 22 April 2008 in Catheter Cardiovasc Interv, 71(6): 727-33.
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