Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul 143-729, Korea.
Korean J Radiol. 2012 Jul-Aug;13(4):467-75. doi: 10.3348/kjr.2012.13.4.467. Epub 2012 Jun 18.
To evaluate the efficacy of various strategies for revascularization of chronic total occlusion of femoropopliteal arteries when the guide wire does not pass in an anterograde direction.
Twenty-four patients with totally occluded femoropopliteal arteries (mean occlusion length 13.75 cm; range, 6-22 cm) were treated by using a retrograde approach and two novel catheters. After successful recanalization or reentry, balloon angioplasty followed by stent placement was performed to complete the revascularization.
In 16 cases in which to cross the occlusion via intraluminal or subintimal route was failed, we used Frontrunner catheters in five cases and Outback catheters in 11 cases. In eight cases in which to reenter after subintimal passage of the guide wire was failed, we used Outback catheters. Successful recanalization was achieved intraluminally or subintimally in all cases. One perforation occurred during subintimal passage of the guide wire that was controlled by recanalization of another subintimal tract. There were no cases of distal thromboembolism or other complications.
A retrograde approach and using the Frontrunner and Outback catheters are safe and effective for successful revascularization of chronic total occlusion of femoropopliteal arteries. In particular, they are useful when the initial antegrade attempts at recanalization have failed.
评估导丝不能沿正向行进时治疗股腘动脉慢性完全闭塞的各种血运重建策略的疗效。
24 例股腘动脉完全闭塞患者（平均闭塞长度 13.75cm；范围 6-22cm）采用逆行入路和两种新型导管进行治疗。成功开通或再进入后，行球囊血管成形术及支架置入术完成血运重建。
16 例经腔内或内膜下途径无法穿过闭塞段的患者中，5 例使用 Frontrunner 导管，11 例使用 Outback 导管。8 例经导丝内膜下通过后再次进入失败的患者，使用 Outback 导管。所有患者均成功经腔内或内膜下开通。1 例在导丝内膜下通过过程中发生穿孔，通过再开通另一条内膜下通道得以控制。无远端血栓栓塞或其他并发症发生。
逆行入路联合 Frontrunner 和 Outback 导管是治疗股腘动脉慢性完全闭塞安全有效的方法。特别是在初次正向开通尝试失败时，这些方法非常有用。
