Work

Endovascular recanalization of superficial femoral artery chronic total occlusions: A multi-disciplinary, single center experience

Year: 2017

Type: article

Abstract: Purpose: The endovascular treatment of CTO in peripheral arteries is common, but little comparative effectiveness data exists to guide clinicians as to which treatment approach is better.We sought to compare procedural outcomes of superficial femoral artery (SFA) chronic total occlusion (CTO) endovascular recanalization using a primary wire approach versus a CTO recanalization device. Methods:We retrospectively identified all patients in an integrated, 3-hospital health system who underwent lower extremity (LE) angiography from 2009-2013.Chart abstraction and angiogram review were performed to identify those patients with de novo SFA CTO who underwent attempted endovascular revascularization by either primary wire approach or CTO recanalization device.Outcomes measured included acute procedural success, volume of contrast dye, fluoroscopy time, and total procedure time.Results: A total of 1,611 patients underwent LE angiography during the study period, and 270 patients were included in the final cohort.There was no significant difference in rates of acute procedural success with primary wire approach when compared with CTO recanalization device (84.5% vs. 77.4%,p=0.32).In the adjusted analysis, there was significantly less contrast use with the use of CTO recanalization device.Conclusions: This study suggests that there is limited difference in acute procedural success rates of SFA CTO revascularization with a CTO recanalization device when compared with a primary wire technique.Larger clinical trials are necessary to demonstrate the value of these devices.

Source: Vascular Diseases and Therapeutics

DOI: 10.15761/vdt.1000119