Use, Safety and Effectiveness of Subintimal Angioplasty and Re-Entry Devices for the Treatment of Femoropopliteal Chronic Total Occlusions: A Systematic Review of 87 Studies and 4,665 Patients

Kokkinidis, Damianos G.; Katsaros, Ioannis; Jonnalagadda, Anil Kumar; Avner, Seth; Chaitidis, Nikolaos; Bakoyiannis, Christos; Kakkar, Amit; Secemsky, Eric A.; Giri, Jay; Armstrong, Ehrin J.

doi:10.1016/j.carrev.2019.03.016

Cited by 20 publications

(11 citation statements)

References 96 publications

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“…Complications reported included manifestation of bleeding at the site of recanalization and angioplasty in four patients at the time of procedure (Jacobs et al, 2006 ). Vurushkan and colleagues reported complications including two distal embolisations, one external iliac artery perforation and two reinterventions due to acute vessel occlusion whereas Kokkinidis and colleagues reported two dissections (Kokkinidis et al, 2020 ). Other studies did not describe the nature of the complications reported (Baker et al, 2015 ; Scheinert et al, 2005 ).…”

Section: Resultsmentioning

confidence: 99%

“…Technical success for subintimal angioplasty (SIA) is 85.7% (Bown et al, 2009 ), which is limited primarily by failure of re-entry to the true lumen, inaccuracy of re-entry and increasing risk of complications (Lipsitz et al, 2003 ; Jacobs et al, 2006 ). In order to bypass the obstruction and re-enter the lumen of the diseased vessel, a re-entry device (RED), such as Intra-Vascular Ultra Sound Pioneer® (Philips, San Diego, California) and fluoroscopically guided Outback® (Cordis, Bridgewater, New Jersey), may be required (Kokkinidis et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

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Use and effectiveness of Pioneer re-entry device for subintimal true lumen re-entry: single-centre data and a review of the literature

et al. 2021

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Introduction During subintimal angioplasty (SIA), it is not always possible to re-enter the vessel lumen due to a variety of factors. Recanalization using hydrophilic wires and catheters alone, apart from its potential technical failure, is also limited by minimal control over the re-entry point. This is frequently well beyond the point of occlusion, thus often compromising important collaterals. In order to bypass the obstruction and attain controlled re-entry into the lumen of the diseased vessel, a re-entry device (RED) may be required. This paper assesses our centre’s experience with the safety and efficacy of the Pioneer re-entry system and systematically reviews the pertinent literature. Method A single centre retrospective study of subintimal angioplasty involving the use of the Pioneer Plus intravascular guided reentry catheter was performed. Patient demographics including age, gender, risk factors, comorbidities clinical indication and complications were recorded. Lesion characteristics, including location and severity of calcification were also assessed. A systematic literature review of all reported studies where the Pioneer RED was used for iliac and lower limb revascularization was conducted by 2 of the authors using the PubMed (MEDLINE) and EMBASE databases. Results The study comprised 30 cases. Technical success was 97%. A small, quickly resolved extravasation was the only device related complication. These results are in line with the systematic review which identified 16 studies using the Pioneer RED, reporting a technical success rate of 87.4–100% (median = 100%) and complication rate of 0–25.8% (median = 0%). However, due to heterogeneity in definitions of technical success, data was not pooled.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Use and effectiveness of Pioneer re-entry device for subintimal true lumen re-entry: single-centre data and a review of the literature

et al. 2021

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“…내막하혈관성형술과 관련하여 최근 발표된 체계적 고찰에 따르면, 총 87개의 연구에서 발표된 결과에서 1년 개통률이 22%에서 94.1%까지 너무 넓은 범위의 값을 나타냈고, 그나마 최근의 연구들은 70%에서 94.1%로 이전보다는 좋은 결과를 보였다. 또한, 시술 후 혈관파열과 같은 합병증도 1.6%에서 28%까지 다양하게 나타났다( 49 ).…”

Section: 대퇴슬와동맥 혈관 내 치료unclassified

Interventional Treatments for Femoropopliteal Arterial Disease and Recent Updates

김

조

2021

J Korean Soc Radiol

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대퇴슬와동맥의 말초동맥폐쇄질환은 일반적으로 죽상경화증에 의해 발생하며, 질병의 정도에 따라 간헐적 파행에서부터 심각한 사지 허혈 또는 조직 손상에 이르는 다양한 증상으로 나타날 수 있다. 따라서, 증상을 개선하고 사지를 형태적, 기능적으로 보존하기 위해서는 적절한 치료가 필요하다. 대퇴슬와동맥 질환에서 시행되는 대표적인 인터벤션 치료로는 혈관 성형술, 스텐트 삽입술, 죽종절제술 등이 있다. 수년에 걸쳐, 혈관 내 재개통술은 최소 침습적이라는 이점과 더불어 시술 방법 및 사용 기기의 지속적인 발전을 토대로 말초동맥폐쇄질환의 치료에 널리 시행되고 있다. 이번 종설에서는 대퇴슬와동맥 질환의 다양한 혈관 내 치료 방법에 대해 소개하고, 문헌 고찰을 통해 현재까지 나온 임상 연구의 결과들을 논의하며, 대퇴슬와동맥질환의 치료에 적용되는 시술 방법에 대한 영상을 제시하여 독자의 이해를 돕고자 한다.

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“…A number of proprietary TORUS Stent Grafts are deployed in a continues and overlapping fashion from the popliteal artery into the femoral vein and from the femoral vein into the SFA through two independent anastomoses in order to create a endovascular bypass from the SFA to the popliteal artery (134). The rationale behind PQ Bypass is based on the fact that there are limited treatment choices for patients with long FP lesions, since endovascular techniques are associated with high TLR and low patency rates, while surgical bypass is associated with lengthier admissions and high risk for procedural complication (8,(135)(136)(137).…”

Section: Percutaneous Bypassmentioning

confidence: 99%

“…In the past, PAD was treated with open surgical approaches but with new technologies, more and more peripheral interventions are performed with an endovascular first approach (2,(7)(8)(9)(10)(11). However, both FP and IP lesions can be very challenging to treat with an endovascular approach (10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Current developments in endovascular therapy of peripheral vascular disease

Kokkinidis¹,

Armstrong²

2020

J Thorac Dis

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More than 200 million people worldwide have peripheral artery disease (PAD) or its most severe manifestation, critical limb ischemia (CLI). While endovascular treatment has become first line therapy in most cases, a number of challenges remain for optimal treatment of femoropopliteal (FP) or infrapopliteal (IP) disease, especially when these lesions are severely calcified, chronic total occlusions (CTOs) or instent restenosis (ISR). Continued evolution of technologies has significantly improved the outcomes for endovascular treatment. A number of new devices are in the pipeline right now, including new paclitaxel eluting stents and balloons, intravascular lithotripsy to treat severely calcified lesions, adventitial delivery of anti-restenotic agents to limit restenosis rates, and percutaneous femoro-popliteal bypass.

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Use, Safety and Effectiveness of Subintimal Angioplasty and Re-Entry Devices for the Treatment of Femoropopliteal Chronic Total Occlusions: A Systematic Review of 87 Studies and 4,665 Patients

Cited by 20 publications

References 96 publications

Use and effectiveness of Pioneer re-entry device for subintimal true lumen re-entry: single-centre data and a review of the literature

Use and effectiveness of Pioneer re-entry device for subintimal true lumen re-entry: single-centre data and a review of the literature

Interventional Treatments for Femoropopliteal Arterial Disease and Recent Updates

Current developments in endovascular therapy of peripheral vascular disease

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