Outcome After Crossing Femoropopliteal Chronic Total Occlusions Based on Optical Coherence Tomography Guidance

Schaefers, Johannes Frederik; Schwindt, Arne; Maritati, Gabriele; Torsello, Giovanni; Pannucio, Giuseppe

doi:10.1177/1538574417740057

Cited by 4 publications

(18 citation statements)

References 38 publications

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“…The Ocelot catheter has shown early clinical results suggestive of a viable treatment option of chronic SFA occlusions with crossing success in 72% of cases and up to 97% with the addition of an assist re-entry device (2,7). In our cohort we encountered a 69% cross rate which was similar to those previously reported in the literature (7,9). Although there was no significant difference between the intima-media thickness or cross sectional plaque area of patients with successfully crossed and uncrossed SFA lesions, the grayscale median differed significantly between patients with uncrossed and crossed superficial femoral arteries at the proximal cap of the lesion.…”

Section: Discussionsupporting

confidence: 89%

“…Physicians can use OCT to image arterial structures and plaque morphology to guide treatment during revascularization procedures (7). Studies have demonstrated that the Ocelot catheter can be utilized safely and effectively to cross TASC D lesions (7,8). The CONNECT II trial demonstrated a 97% total cross rate with a 72% cross rate using the Ocelot catheter alone (2).…”

Section: Introductionmentioning

confidence: 99%

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Optical coherence tomography and plaque morphology for revascularization of the superficial femoral artery

Hartwig¹,

Braet²,

Smith³

et al. 2021

Quant Imaging Med Surg

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Background: The optical coherence tomography (OCT) catheter, Ocelot (Avinger Inc., Redwood City, CA), has been utilized to cross Trans-Atlantic Inter-Society Consensus Document (TASC) D lesions. Studies have assessed the characteristics of high-risk plaques in the carotid artery, but few, if any data exist evaluating OCT and plaque morphology in the superficial femoral artery (SFA). This study assessed SFA plaque morphology using OCT and lesion crossing success in chronic total occlusions (CTOs).Methods: We reviewed patients who underwent attempted infrainguinal revascularization with TASC D CTOs using the Ocelot catheter between June 2014 and June 2018, and recorded demographic information, smoking status, and medical comorbidities. A matched cohort of 44 successfully crossed lesions was compared to 44 that failed; images insufficient for analysis were excluded. The morphology of the plaque was studied using OCT at the proximal cap, midpoint of the lesion, and the distal cap. Morphologic data studied included the intima-media thickness ratio, cross-sectional area of the plaque, and gray-scale median of the plaque.Results: A total of 140 patients who underwent lower extremity procedures for TASC D lesions of the SFA with OCT imaging were reviewed with a crossing rate of 69.0%. No significant differences were found between crossed and uncrossed lesions for intima-media thickness or cross-sectional area at the proximal cap, the midpoint, or the distal cap. A lower gray-scale median at the proximal cap was associated with the ability to cross the chronic SFA occlusion (P=0.05). Subgroup analysis stratified by smoking and calcium content also demonstrated that a lower gray-scale median at the proximal cap was associated with the ability to cross the chronic SFA occlusion (P=0.01 and P=0.04, respectively).Conclusions: Lower gray-scale median at the proximal cap of a chronic SFA occlusion calculated using OCT images was associated with the ability to successfully cross the lesion. Higher plaque gray-scale median is correlated with increased calcium, greater fibrous tissue, and signal-rich plaques. Gray-scale median in the proximal cap is useful marker to determine plaque composition and subsequent technical success for crossing chronic SFA occlusions. Further studies are needed to fully determine the utility of OCT images to predict successful endovascular revascularization of chronic SFA occlusions.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Optical coherence tomography and plaque morphology for revascularization of the superficial femoral artery

Hartwig¹,

Braet²,

Smith³

et al. 2021

Quant Imaging Med Surg

View full text Add to dashboard Cite

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“…Most articles (n = 10) reported data concerning the performance and efficacy of the application of OCT in therapeutic means. [36][37][38][39][40][41][42][43][44][45] One article 46 discussed the decrease in fluoroscopic exposure when comparing OCT and other atherectomy devices, and another discussed a unique case scenario where the use of OCT to prevent bailout stenting. For the 10 articles, population sizes range from 1 to 272 lesions.…”

Section: Oct For Intervention Of Padmentioning

confidence: 99%

“…The femoropopliteal segments were studied the most (n = 6), [36][37][38][39][40][41] while there was only one study involving iliac arteries. 45 Two studies 40,44 did not report on what type of OCT-related device was used, but all of the remaining studies used the Ocelot catheter, 38,39,[41][42][43]45 and two other studies used Pantheris concomitantly. 36,37 The mean lesion length treated ranged from 50mm to 205mm.…”

Section: Oct For Intervention Of Padmentioning

confidence: 99%

“…Both the primary patency rates (PPR) and the secondary patency rates (SPR) were reported in two studies, both of which had higher SPR. Specific target lesion revascularisation (TLR) was reported in five studies, 36,37,[39][40][41] and ranges from 0% to 78.9% within 6 months. Mean procedure time was recorded in four studies, 38,39,42,44 with a range of 83 to 150 minutes.…”

Section: Oct For Intervention Of Padmentioning

confidence: 99%

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Optical coherence tomography in peripheral arterial disease: A systematic review

Tung

Yim

et al. 2021

Int J Clin Pract

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Optical coherence tomography (OCT) is an imaging technique analogous to ultrasound, using light instead of sound waves. 1 It utilises interferometry to map the reflectivity of light in terms of depth to provide high-resolution, cross-sectional images of the internal tissues. 2 Upon its first realisation by Huang et al for imaging of the retina and the coronary arteries in 1991, 3 it was initially utilised in the field of ophthalmology. 4,5 Owing to its high resolution of images, it was subsequently applied in cardiology, 6 dermatology, 7 oncology, 8 dentistry, 9 as well as endoscopic visualisation of hollow organs like the gastrointestinal tract 10 and the airway. 11 Atherosclerosis is a prevalent and disabling disease with occlusion and stenosis of the systemic arteries other than cerebral and coronary circulation. 12 Despite the evolving pharmacological intervention in symptomatic control, revascularisation remains the treatment of choice in chronic lower limb occlusive disease, presenting with short distance claudication, rest pain, arterial

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Intravascular Imaging for Peripheral Vascular Disease and Endovascular Intervention

Rothstein

Aronow

Hawkins

et al. 2020

Curr Cardiovasc Imaging Rep

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Outcome After Crossing Femoropopliteal Chronic Total Occlusions Based on Optical Coherence Tomography Guidance

Abstract: In our experience, the Ocelot system would appear to be a safe and effective tool for increasing the applicability of endovascular techniques. However, the midterm results did not show drastic improvement.

Cited by 4 publications

References 38 publications

Optical coherence tomography and plaque morphology for revascularization of the superficial femoral artery

Optical coherence tomography and plaque morphology for revascularization of the superficial femoral artery

Optical coherence tomography in peripheral arterial disease: A systematic review

Intravascular Imaging for Peripheral Vascular Disease and Endovascular Intervention

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