Azzaretti Andrea, Trevisan Daniele, Fachinetti Camilla, Borghi Claudia, Vannelli Alberto
FF UOC Radiodiagnostica, Valduce Hospital, Via Dante Alighieri 11, 22100, Como, Italy.
U.O.C. Chirurgia Generale, Valduce Hospital, Via Dante Alighieri, 11, 22100, Como, Italy.
CVIR Endovasc. 2021 Jul 7;4(1):57. doi: 10.1186/s42155-021-00244-4.
Recanalization of graft limb occlusion can prove challenging and the use of the GoBack crossing and reentry device may be a suitable option, especially when there is no other way to restore flow with an usual endovascular approach. The GoBack catheter is a novel device designed to enhance pushability, and to enable direction-change inside hard plaques and crossing of tough lesions, even when they involve graft fabric.
It's reported a case of a 76-year-old male who presented with claudication, previous placement of an aorto-bi iliac graft by open surgery for a ruptured abdominal aneurysm 10 years ago that, over time, developed severe kinking on the left limb and a fabric occlusion on the right limb. After several unsuccessful attempts to cross the occlusion of the right common iliac artery, the GoBack™ was deployed to create a lumen through graft's folds. After angioplasty and stenting a satisfactory result was achieved, restoring flowCT-scan at 1 month and duplex ultrasound (DUS) at 3 months confirmed the patency of ilio-femoral axis.
The advent of this new CTO crossing device has the potential to facilitate recanalization of some of the most challenging occlusions. Facilitating more consistent distal entry and allowing for a decrease in crossing time. Therefore, the GoBack catheter should be considered as a potential complementary tool to treat vascular occlusions via endovascular approaches, especially when classical endovascular techniques fail.
移植肢体闭塞的再通可能具有挑战性,使用GoBack穿越和再入装置可能是一个合适的选择,特别是当没有其他方法通过常规血管内方法恢复血流时。GoBack导管是一种新型装置,旨在增强推送能力,并能够在硬斑块内改变方向以及穿越坚硬病变,即使这些病变涉及移植织物。
报道了一例76岁男性患者,该患者有间歇性跛行症状,10年前因腹主动脉瘤破裂接受开放手术植入了主动脉-双髂动脉移植物,随着时间的推移,左下肢出现严重扭结,右下肢出现织物闭塞。在多次尝试穿越右髂总动脉闭塞失败后,使用GoBack™装置穿过移植物褶皱创建了一个管腔。经过血管成形术和支架置入术后,取得了满意的效果,恢复了血流。1个月后的CT扫描和3个月后的双功超声(DUS)证实了髂股轴的通畅。
这种新型慢性完全闭塞(CTO)穿越装置的出现有可能促进一些最具挑战性的闭塞病变的再通。有助于更一致的远端进入并减少穿越时间。因此,GoBack导管应被视为通过血管内方法治疗血管闭塞的一种潜在辅助工具,特别是在经典血管内技术失败时。