Hydrodynamic boost: a novel re-entry technique in subintimal angioplasty of below-the-knee vessels.
Eur Radiol
; 26(8): 2419-25, 2016 Aug.
Article
en En
| MEDLINE
| ID: mdl-26560722
ABSTRACT
OBJECTIVES:
To describe the hydrodynamic boost (HB) technique and report our preliminary results with this technique in the subintimal angioplasty of below-the-knee vessels.METHODS:
HB was used in 23 cases (14 males, mean age 73 ± 12 years) of critical limb ischemia, with long chronic total occlusion of tibial arteries extended to the ankle level. The operator performs a manual injection of diluted contrast dye through a 4 F catheter into the subintimal space, close to the patent true distal lumen, in order to achieve a tear in the intimal flap and a connection with the true lumen.RESULTS:
In 19/23 (83 %) cases, the HB was effective in creating a connection between the subintimal space and the true distal lumen and it was possible to advance a wire and to conclude the procedure. In 4/23 (17 %) lesions, the HB failed and the procedure was successfully completed by retrograde approach. No major complications occurred. Mean length between catheter tip and re-entry point was 8 ± 5 mm.CONCLUSIONS:
HB seems to be a feasible, safe and effective re-entry technique in distal below-the-knee vessels. This method represents an easy option for re-entry that extends the possibility of antegrade approach to obtain a successful revascularization. KEY POINTS ⢠In subintimal angioplasty of below-the-knee vessel re-entry can represent a challenge. ⢠Inability to re-enter may determine the failure of the revascularization procedure. ⢠HB is a novel re-entry technique feasible in distal below-the-knee vessels. ⢠HB may increase the success rate of antegrade approach. ⢠In case of failure, retrograde approach remains feasible.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Arteriopatías Oclusivas
/
Angioplastia
Límite:
Aged
/
Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur Radiol
Asunto de la revista:
RADIOLOGIA
Año:
2016
Tipo del documento:
Article
País de afiliación:
Italia