First case reports of controlled blunt microdissection for percutaneous transluminal angioplasty of chronic total occlusions in peripheral arteries

Abstract

Percutaneous transluminal angioplasty (PTA) can fail to revascularize peripheral arteries when a chronic total occlusion (CTO) cannot be crossed by guidewires. This article describes application of a new controlled blunt microdissection (CMD) catheter designed to cross CTOs. Two men presenting with severe claudication had iliac CTOs that resisted crossing with guidewires. Using standard techniques, the CMD catheter was advanced to the CTO. Following attempts to cross the CTO with guidewires, the jaw of the CMD distal assembly was actuated, advancing through the CTO as plaque was blunt-dissected. After angioplasty and stenting, restored distal flow was restored. Ischemic symptoms had not recurred at 1- and 28-month follow-up. The concept of blunt intraluminal microdissection has been applied to convert failing to successful PTA of peripheral arteries. CTOs that had resisted guidewire crossing were successfully crossed using the CMD catheter, allowing treatment by angioplasty and stenting.

Recanalization of chronic total peripheral arterial occlusions using optical coherent reflectometry with guided radiofrequency energy: A single center experience

“…CTOs that had resisted conventional guidewire crossing have been successfully crossed by excimer laser‐assisted angioplasty in long SFA occlusions allowing treatment by angioplasty and stenting thereby converting failed to successful percutaneous treatment of peripheral CTOs [18]. Furthermore, patency of these CTO crossings has been shown to endure from 12 to 28 months [18, 19].…”

Novel devices and specialized techniques in recanalization of peripheral artery chronic total occlusions (CTOs) — A literature review

“…In 2003, Mossop et al [7] first used this catheter in two men presenting with iliac CTOs that were resistant to crossing with guidewires and achieved successful recanalization. In another published article Mossop and colleagues [8] showed in a small prospective series involving 36 patients with 44 CTOs, that procedural success was achieved in 40 (91%) lesions.…”

Recanalization of Femoropopliteal Chronic Total Occlusions Using the ENABLER-P Balloon Catheter System

“…[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22], with a mean overall procedure duration from ENABLER-P catheter anchoring to withdrawal of 14.7 minutes (range 1-44).…”