Subject(s)
Atherectomy , Femoral Artery , Popliteal Artery , Vascular Calcification , Humans , Femoral Artery/diagnostic imaging , Popliteal Artery/diagnostic imaging , Vascular Calcification/diagnostic imaging , Vascular Calcification/therapy , Atherectomy/methods , Male , Aged , Tomography, Optical Coherence/methods , Peripheral Arterial Disease/diagnostic imaging , Peripheral Arterial Disease/therapy , Peripheral Arterial Disease/surgery , FemaleABSTRACT
BACKGROUND: Supera interwoven stents (IWS) have a unique interwoven structure; thus, precise stent placement can be challenging as they are prone to elongation, shortening, and invagination. Particularly, invagination limits long-term patency. This proposed method aims to remove invaginated IWS. CASE PRESENTATION: A 70-year-old man presented with intermittent claudication in his left lower limb. Endovascular therapy was conventionally performed, and a 5.5 × 40 mm IWS was placed after balloon dilatation; however, invagination occurred. The invaginated IWS was successfully removed by a threading 0.014" wire through the outside of the stent strut, and a snare catheter was used to hold it in place from the inside. Then, while still in place, the 0.014" wire and snare catheter were driven into the guiding sheath. CONCLUSIONS: This practical and easy approach to remove invaginated IWS from the body relies on the particular structural characteristics.
ABSTRACT
Chronic total occlusion (CTO) in the femoropopliteal artery is challenging to treat. The Wingman catheter system is a novel device for CTO penetration with a nitinol/stainless steel beveled tip. There is a lack of real-world clinical data indicating the success rate. We evaluated the efficacy of the Wingman system. This was a single-center retrospective study. We enrolled 27 consecutives patients who underwent treatment for femoropopliteal CTO using the Wingman system in 2021. The primary outcome was success of CTO-crossing and secondary outcomes were success of the procedure, Wingman-related complications, and predictors for success of Wingman crossing. The mean age of the study population was 76 years and the mean CTO length was 122 mm. The success rate of Wingman crossing was 40.7% and the overall procedure success rate was 100%. Only one case of embolism and one of perforation associated with the Wingman procedure were seen; both were successfully recovered. Univariate analysis revealed in-stent occlusion and non-severe calcification to be factors associated with success (16.7% vs 0%, p = 0.012 and 12.5% vs 50.0%, p = 0.036, respectively). These real-world data of the Wingman system demonstrate it to be a safe and one of option for treating femoropopliteal CTO.
