Subintimal recanalization for peripheral artery total occlusion / 中华放射学杂志

ABSTRACT

Objective To assess the technique and clinical outcome of subintimal recanolization (SIR)for peripheral artery total occlusion.Methods Eighteen patients with 20 arterial occlusions underwent SIR.The occlusive lesions were located in the lilac-femoral artery(14 lesions),the infrapopliteal arteries(4 lesions)and the left subclavian artery(2 lesions),respectively.Basic procedure of SIR was to create a subintimal path in the wall of the occluded artery and reentry the true lumen by using 0.035 inch diameter TERUMO guidwire and angiographic catheter.Subsequently,balloon angioplasty was performed in all recanalized lesions,and stent was placed in initial parts or whole recanalized path except one lesion in the lilac-femoral artery,and the lesions in the infrapopliteal arteries.Results Seventeen occlusive lesions in 15 patients were successfully recanalized by means of SIR,and the corresponding symptoms were disappeared or improved obviously.Technical failure occurred in 3 patients due to inability to reenter the distal true lumen or balloon angioplasty was not satisfactory.No complications of artery rupture,thrombosis or embolization were found.Conclusion SIR is an effective and safe therapy for peripheral artery total occlusion.This technique provides a feasible alternative to conventional percutaneous transluminal angioplasty especially in the complicated cases.