Clinical impact of intravascular ultrasound‐guided balloon angioplasty in patients with chronic limb threatening ischemia for isolated infrapopliteal lesion

Soga, Yoshimitsu; Takahara, Mitsuyoshi; Ito, Nobuhiro; Katsuki, Tomonori; Imada, Kazuaki; Hiramori, Seiichi; Tomoi, Yusuke; Ando, Koji

doi:10.1002/ccd.29347

Cited by 22 publications

(9 citation statements)

References 20 publications

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“…In conclusion, with the increasing use of IVUS-guided EVT for the management of patients with chronic limb-threatening ischemia ( 13 ), the number of such reports may increase in the future.…”

Section: Discussionmentioning

confidence: 99%

A Lotus Root-like Appearance in the External Iliac Artery Detected by Intravascular Ultrasonography

et al. 2022

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A lotus root-like appearance on blood vessels is a rare abnormality. The multiple channels within arteries may represent the recanalization or neovascularization of the thrombus. This abnormality is most frequently found in coronary arteries. A 39-year-old woman had a thrombus-like structure in the external iliac artery. We subsequently performed an endovascular treatment six months later due to intermittent claudication. A lotus root-like appearance was found on intravascular ultrasound. To our knowledge, this is the first study to report a case of lotus root-like appearance in lower-extremity arteries.

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Section: Discussionmentioning

confidence: 99%

A Lotus Root-like Appearance in the External Iliac Artery Detected by Intravascular Ultrasonography

et al. 2022

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“…In recent years, IVUS has been used to determine the appropriate vessel diameter for BTK lesions, and clinically, it has accelerated improvements in wound care (Fujihara et al 2020 ; Soga et al 2021 ). In addition to the evaluation of the appropriate vessel diameter, the AnteOwl may also allow guidewire passage in difficult cases and reduce the incidence of distal puncture.…”

Section: Discussionmentioning

confidence: 99%

An AnteOwl WR intravascular ultrasound-guided parallel wiring technique for chronic total occlusion of below-the-knee arteries

et al. 2022

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Background Although endovascular therapy is used to treat chronic limb-threatening ischemia, long chronic total occlusion (CTO) is still challenging to treat. Especially in patients with poor run-off below-the-knee (BTK) arteries, it is difficult to perform a retrograde approach, and even guidewire passage may be difficult. Case presentation We treated two cases of chronic limb-threatening ischemia using our novel extreme antegrade guidewire crossing technique by AnteOwl WR intravascular ultrasound (IVUS)-guided parallel wiring to a BTK artery (EXCAVATOR technique). Case 1 was a 70-year-old man with ulceration of the right toe. The AnteOwl WR IVUS was intentionally advanced into the subintimal space of the posterior tibial artery, and the totally intraplaque route was advanced by IVUS-guided parallel wiring that was successfully passed from the lateral plantar aspect to the true lumen of the digital artery. Case 2 was a 76-year-old woman with rest pain and cyanosis of the right lower limb. Angiography showed total occlusion from the superficial femoral artery to BTK arteries. AnteOwl WR IVUS-guided parallel wiring was repeatedly performed until the distal true lumen of the peroneal artery was reached, and revascularization was successfully achieved via the antegrade approach alone. Conclusions With its excellent crossable performance, good image quality, and high navigational ability within the CTO, the AnteOwl WR can be used to pass parallel wiring into the distal true lumen for BTK CTO.

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“…Several studies suggest that IVUS improves gain in vessel diameter and stent patency and resultant freedom from reintervention. [12][13][14][15][16] IVUS also enhances sensitivity for detecting procedural complications, including arterial dissections. [17][18][19][20][21][22] This may result in important changes to the treatment plan to minimize short-term peri-procedural complications.…”

Section: Discussionmentioning

confidence: 99%

Intravascular ultrasound in peripheral venous and arterial interventions: A contemporary systematic review and grading of the quality of evidence

et al. 2022

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Although angiography has been the primary imaging modality used in peripheral vascular intervention, this technique has major limitations due to the evaluation of three-dimensional vessels in two dimensions. Intravascular ultrasound (IVUS) is an important adjunctive tool that can address some of these limitations. This systematic review assesses the appropriateness of IVUS as an imaging modality for guiding peripheral intervention through evidence collection and clinical appraisal of studies. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a cohort of 48 studies (29 arterial; 19 venous) detailing IVUS use in peripheral vascular intervention were extracted. Qualitative assessment of the studies evaluated pre- and postprocedure efficacy of IVUS and revealed that IVUS-guided peripheral intervention in arterial and venous diagnosis and treatment was superior to other imaging techniques alone. Each study in the cohort was further assessed for reliability and validity using the Oxford Centre for Evidence Based Medicine (CEBM) level of evidence scale. The majority of both arterial (79.3%) and venous (73.7%) studies received a 2b rating, the second highest level of evidence rating. The evidence to date indicates that IVUS results in better clinical outcomes overall and should be more widely adopted as an adjunctive imaging modality during peripheral intervention. (PROSPERO Registration No.: CRD42021232353)

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Clinical impact of intravascular ultrasound‐guided balloon angioplasty in patients with chronic limb threatening ischemia for isolated infrapopliteal lesion

Cited by 22 publications

References 20 publications

A Lotus Root-like Appearance in the External Iliac Artery Detected by Intravascular Ultrasonography

A Lotus Root-like Appearance in the External Iliac Artery Detected by Intravascular Ultrasonography

An AnteOwl WR intravascular ultrasound-guided parallel wiring technique for chronic total occlusion of below-the-knee arteries

Intravascular ultrasound in peripheral venous and arterial interventions: A contemporary systematic review and grading of the quality of evidence

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