Cannavale Alessandro, Ali Tariq, Shen Chen-Yang, Kassimis George, Krokidis Miltiadis
a Department of Radiology , Cambridge University Hospitals NHS Foundation Trust , Cambridge , UK.
b Department of Peripheral Vascular Surgery , Fuwai Hospital, National Center for Cardiovascular Diseases , Beijing , China.
Expert Rev Cardiovasc Ther. 2017 Mar;15(3):221-225. doi: 10.1080/14779072.2017.1297229. Epub 2017 Feb 24.
Chronic total occlusions (CTOs) are challenging to treat endovascularly. Classic subintimal approach is offering only moderate success rates mainly due of the lack of dedicated crossing catheters. Purpose of this study is to assess the acute procedural success of the use of a novel hydrophilic crossing catheter in the recanalization of peripheral CTOs.
This is a retrospective, single-centre study of patients with femoropopliteal CTOs. Revascularization was performed with the use of the NaviCross®- crossing catheter (Terumo Europe). Technical, procedural success and complications were assessed.
Thirty-two patients were included in the study. Mean age was 65.9 (46-85) years; Critical limb ischemia was the indication for the procedure in 26 (81%). Target vessels included 12 superficial femoral arteries, 9 popliteal, and 11 femoropopliteal segment lesions. Mean length was 85 (50-350) mm; 21(65.6%) lesions were heavily calcified. In all cases a sub-intimal approach was used; in 21 cases the procedure was performed as a day case. Technical success was achieved in 31 (96.8%) cases. Recanalization was achieved with a guidewire in 22 (71%) lesions and with the catheter alone in 9 (29%) cases. Procedural success was achieved in all lesions. No major adverse events occurred.
The use of the NaviCross®- crossing catheter showed high rate of technical and procedural success in challenging femoropopliteal CTOs without significant complications. The use of this catheter needs to be considered as the first approach for CTOs prior to the use of any other more complex re-entry device.
慢性完全闭塞病变（CTO）的血管内治疗具有挑战性。经典的内膜下途径成功率仅为中等水平，主要原因是缺乏专用的穿刺导管。本研究的目的是评估使用新型亲水穿刺导管对周围CTO进行再通的急性手术成功率。
这是一项针对股腘动脉CTO患者的回顾性单中心研究。使用NaviCross®穿刺导管（泰尔茂欧洲公司）进行血管重建。评估技术、手术成功率和并发症。
32例患者纳入研究。平均年龄为65.9岁（46 - 85岁）；26例（81%）患者的手术指征为严重肢体缺血。目标血管包括12条股浅动脉、9条腘动脉和11条股腘段病变。平均长度为85毫米（50 - 350毫米）；21例（65.6%）病变严重钙化。所有病例均采用内膜下途径；21例手术作为日间手术进行。31例（96.8%）手术获得技术成功。22例（71%）病变通过导丝实现再通，9例（29%）仅通过导管实现再通。所有病变均获得手术成功。未发生重大不良事件。
在具有挑战性的股腘动脉CTO治疗中，使用NaviCross®穿刺导管显示出较高的技术和手术成功率，且无明显并发症。在使用任何其他更复杂的再入装置之前，应考虑将该导管作为CTO治疗 的首选方法。
