1 Department of Radiology, Guy's and St Thomas' NHS Trust, St Thomas' Hospital, London, UK.
2 Kings College London, School of Medicine, London, UK.
J Endovasc Ther. 2018 Apr;25(2):178-182. doi: 10.1177/1526602818757409. Epub 2018 Feb 13.
To report use of the Outback reentry device for targeted distal reentry during subintimal recanalization of chronic total occlusions (CTOs) in the infragenicular arteries.
During an 18-month period, the Outback device was applied in 10 patients (mean age 71.8±18.8 years; 8 men) to achieve reentry at the infragenicular segment following either unsuccessful spontaneous reentry after subintimal crossing of a CTO or when a targeted reentry was desired. The mean occlusion length was 117.5±101.0 mm. Technical (device) success, overall procedure success, and reentry accuracy are reported, along with any major or minor complications.
The device was technically successful in achieving reentry in 9 of 10 cases; overall procedure success was achieved in 8 owing to heavy calcifications in a distal posterior tibial artery and a distal popliteal artery. The reentry accuracy was 10.8±14.6 mm. There were no major complications and only 3 minor sequelae, including 2 dissections and 1 small perforation; all were treated successfully with stenting.
The Outback device has a high technical success rate in achieving targeted true lumen reentry in infragenicular subintimal angioplasty when spontaneous reentry is not possible or a targeted reentry is desirable.
报告使用 Outback 再入装置在膝下动脉的慢性完全闭塞（CTO）的内膜下再通中进行靶向远端再入的情况。
在 18 个月的时间内，10 名患者（平均年龄 71.8±18.8 岁；8 名男性）应用 Outback 装置，在 CTO 内膜下穿过后未能自发再入或需要靶向再入时，在膝下段实现再入。平均闭塞长度为 117.5±101.0mm。报告了技术（器械）成功率、整体手术成功率和再入准确性，以及任何主要或次要并发症。
9 例中的 10 例器械技术上成功实现再入；8 例整体手术成功，原因是胫骨后动脉和腘动脉远端严重钙化。再入准确性为 10.8±14.6mm。无主要并发症，仅有 3 例轻微后遗症，包括 2 例夹层和 1 例小穿孔；均成功地进行了支架治疗。
当自发再入不可能或需要靶向再入时，Outback 装置在膝下内膜下血管成形术中实现靶向真腔再入的技术成功率很高。
