Efficacy of Multichannel Balloon Angioplasty in Calcified Common Femoral Artery Lesions

Nagatomi, Satoru; Ichihashi, Shigeo; Yamamoto, Hiroshi; Iwakoshi, Shinichi; Taguchi, Hidehiko; Inagaki, Masumi; Yoshiyama, Yutaka; Nakai, Takahiro; Shimohara, Yuichi; Bolstad, Francesco; Kichikawa, Kimihiko

doi:10.1016/j.jvir.2020.10.018

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…A novel approach, stent-assisted angioplasty of CFA lesions showed satisfactory technical success, with low restenosis rate during the follow-up but with high mortality rate [13]. On the other hand, multichannel balloon angioplasty of heavily calcified CFA lesions has been described as well, with good initial results [14].…”

Section: Discussionmentioning

confidence: 98%

Antegrade dissection of external iliac artery after failed attempt of common femoral artery chronic total occlusion angioplasty

et al. 2022

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Introduction. Endovascular treatment of chronic total occlusion (CTO) represents a true challenge even for experienced interventional radiologists. We are presenting a case of hidden antegrade dissection of external iliac artery (EIA) after failed attempt to recanalize CTO of common femoral artery (CFA). Case outline. Fifty-two-year-old male patient was admitted for multidetector computed tomography angiography. Left common iliac artery (CIA) stenting was performed followed by ?crossover? attempt of recanalization of right CFA CTO that failed. The next day, left femoral superficial artery angioplasty was performed and after one month, angioplasty of the left popliteal and bellow knee arteries. A month later the patient was readmitted for surgical reconstruction of the CFA. After desobstruction, excellent inflow was obtained and Dacron graft inserted. A few hours postoperatively, Fogarty catheter thrombectomy was performed. The next morning pulsations were weakened again and CT angiography showed antegrade dissection of the EIA. Stenting of the EIA was performed with two stents and favourable outcome. After detailed analysis of CT, hidden thrombosed antegrade dissection of EIA was noted in lateral view, that was not seen in posterior/anterior view and was presented as fibrous plaque with mural thrombosis. Dissection occurred after failed attempt of CFA recanalization and was clinically silent until flow was established triggering opening of the false lumen and release of thrombotic masses. Conclusion. In patients with failed angioplasty of chronic total occlusion of CFA and CT characteristics of fibrous plaque proximal of the site of attempted angioplasty, thrombosed antegrade dissection should be thought of.

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Section: Discussionmentioning

confidence: 98%

Antegrade dissection of external iliac artery after failed attempt of common femoral artery chronic total occlusion angioplasty

et al. 2022

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“…Nagatomi S and colleagues reported SMASH technique. 13 This technique resembled the ARCADIA technique in the point of expanding the calcified plaque. The difference point was the number of routes passing through the calcified plaque.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Aggressive Wire Recanalization in Calcified Atheroma and Dilatation (ARCADIA) Technique in Eccentric Calcified Lesion of No-stenting Zone

et al. 2021

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Purpose: The endovascular approach for eccentric calcified lesions of the no-stenting zone is challenging. This study aimed to investigate the effect of a novel technique for these lesions. Methods: We performed EVT for severe and eccentric calcified lesions using the technique, which is presented previously and named aggressive wire recanalization in calcified atheroma and dilatation (ARCADIA). In brief, a guidewire is passed to the residual lumen firstly. Next, another guidewire is advanced into and cross through the calcified plaque and returned to the distal original lumen with intravascular ultrasound (IVUS) guided. The calcified plaque is dilated by using a scoring-balloon or non-compliant balloon. Results: Consecutive 14 peripheral artery disease patients with isolated and eccentric calcification in a no-stenting zone were treated using ARCADIA technique between January 2018 and March 2020. In IVUS data, lumen cross-section area was significantly increased from 5.2 ± 2.0 mm2 to 18.1 ± 6.9 mm2 (p < 0.01), lumen area was expanded roundly evaluating as symmetry index from 0.45 ± 0.09 to 0.81 ± 0.12 (p < 0.01). There were no distal embolization and perforation after ARCADIA technique. One-year target lesion revascularization occurred in only 2 cases. The primary patency of 1 year was 85.7%. Conclusion: ARCADIA technique is safe and appropriate, and can be 1 option to treat for eccentric calcified lesions of the no-stenting zone as an optimal wire crossing method.

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“…8 A multichannel balloon angioplasty technique was developed specifically to address eccentric calcific plaques; however, very limited short-term data exist with no significant benefit noted. 9 The utility of DCB angioplasty in many areas of arterial and venous work has shown promise of improved mid-term patency; unfortunately, the benefit of DCB over other adjunct methods remains mixed, particularly in the setting of eccentric plaque. 10,11 The use of scoring balloon angioplasty in the setting of calcified plaque with primary goal of optimizing DCB drug delivery and achieving improved luminal gain has shown no true benefit over angioplasty alone.…”

Section: Angioplastymentioning

confidence: 99%

Surgical, Endovascular, and Multimodal Approaches to the Management of Atherosclerotic Common Femoral Artery Disease

Kugler

2023

Semin intervent Radiol

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Common femoral artery disease is at the heart of nearly all treatment algorithms and decisions for patients with symptomatic peripheral arterial disease. Surgical endarterectomy has been the mainstay of common femoral treatment with a wealth of data supporting its safety, efficacy, and durability. Advances in endovascular technology and techniques for the management of iliac and superficial femoral artery disease has resulted in a paradigm shift in management. The common femoral artery has been aptly named a “no stent zone” due to anatomic and disease-specific challenges that have limited the role for endovascular techniques. New technology and techniques in the endovascular management of common femoral disease seek to change our treatment strategies. A multimodal approach utilizing a combination of angioplasty, atherectomy, and stenting has been shown most beneficial, although limited long-term data leave durability an unanswered question. While surgical treatment remains the gold standard, advances in the endovascular approach will certainly continue to improve outcomes. As truly isolated common femoral disease is a rarity, a collaborative approach combining all benefits of open and endovascular techniques in the treatment of peripheral arterial disease is essential.

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Efficacy of Multichannel Balloon Angioplasty in Calcified Common Femoral Artery Lesions

Cited by 4 publications

References 14 publications

Antegrade dissection of external iliac artery after failed attempt of common femoral artery chronic total occlusion angioplasty

Antegrade dissection of external iliac artery after failed attempt of common femoral artery chronic total occlusion angioplasty

The Effect of Aggressive Wire Recanalization in Calcified Atheroma and Dilatation (ARCADIA) Technique in Eccentric Calcified Lesion of No-stenting Zone

Surgical, Endovascular, and Multimodal Approaches to the Management of Atherosclerotic Common Femoral Artery Disease

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