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Usefulness of ultrasound-guided intraluminal approach for long occlusive femoropopliteal lesion.

Abstract
To investigate the usefulness of ultrasound-guided (USG) intraluminal approach for femoropopliteal (FP) lesion. 64 patients (73 limbs) with de novo long occlusive (> 15 cm) FP lesions underwent USG intralumial approach from April 2012 to October 2016. Periprocedural intravascular ultrasound findings were collected. Clinical outcome and predictors of restenosis after USG intraluminal approach for de novo long occlusive FP lesion were investigated. Among the study participants, 34% were female, 50% had diabetes mellitus, and 10% received hemodialysis. Lesion and chronic total occlusion (CTO) lengths were 222 ± 55 mm and 201 ± 55 mm, respectively. Procedural success was achieved in 72 lesions (99%). Distal puncture was performed in 7 limbs (10%). The proportion of within-CTO intraplaque, subintimal, and medial routes were 87 ± 21%, 9 ± 15%, and 4 ± 11%, respectively. Primary patency was 71% and 69% at 1 and 2 years. Multivariate analysis revealed that within-CTO intraplaque route proportion [hazard ratio (HR) 0.81; 95% confidence interval (CI) 0.67-0.98, p = 0.0339] and lesion length (HR 1.11; CI 1.00-1.22; p = 0.0447) were independent predictors of restenosis.USG intraluminal approach facilitated acquisition of within-CTO intraplaque route in long occlusive FP lesions and could improve clinical outcome.
AuthorsShinsuke Mori, Keisuke Hirano, Masahiro Yamawaki, Norihiro Kobayashi, Yasunari Sakamoto, Masakazu Tsutsumi, Yohsuke Honda, Kenji Makino, Shigemitsu Shirai, Yoshiaki Ito
JournalHeart and vessels (Heart Vessels) Vol. 36 Issue 3 Pg. 376-382 (Mar 2021) ISSN: 1615-2573 [Electronic] Japan
PMID32889645 (Publication Type: Journal Article, Observational Study)
Topics
  • Arterial Occlusive Diseases (diagnosis, physiopathology, surgery)
  • Endovascular Procedures (methods)
  • Female
  • Femoral Artery
  • Follow-Up Studies
  • Humans
  • Male
  • Popliteal Artery
  • Retrospective Studies
  • Surgery, Computer-Assisted (methods)
  • Treatment Outcome
  • Ultrasonography, Interventional (methods)
  • Vascular Patency

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