Five-year outcomes after revascularization of superficial femoral artery occlusion using Ocelot catheter

Nowakowski, Przemysław; Buszman, Piotr P.; Janas, Adam; Kiesz, Stefan; Buszman, Paweł

doi:10.5114/aic.2019.90222

Cited by 3 publications

(1 citation statement)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients were considered eligible when diagnosed with chronic limb ischemia grade 3, target vessel diameter >5 mm, and total occlusion of the target vessel. Patients with a high medical comorbidity burden who desire a minimally invasive endovascular treatment with reduced recovery time were considered for revascularization with the Ocelot catheter (11).…”

Section: Patient Selectionmentioning

confidence: 99%

Optical coherence tomography and plaque morphology for revascularization of the superficial femoral artery

Hartwig¹,

Braet²,

Smith³

et al. 2021

Quant Imaging Med Surg

View full text Add to dashboard Cite

Background: The optical coherence tomography (OCT) catheter, Ocelot (Avinger Inc., Redwood City, CA), has been utilized to cross Trans-Atlantic Inter-Society Consensus Document (TASC) D lesions. Studies have assessed the characteristics of high-risk plaques in the carotid artery, but few, if any data exist evaluating OCT and plaque morphology in the superficial femoral artery (SFA). This study assessed SFA plaque morphology using OCT and lesion crossing success in chronic total occlusions (CTOs).Methods: We reviewed patients who underwent attempted infrainguinal revascularization with TASC D CTOs using the Ocelot catheter between June 2014 and June 2018, and recorded demographic information, smoking status, and medical comorbidities. A matched cohort of 44 successfully crossed lesions was compared to 44 that failed; images insufficient for analysis were excluded. The morphology of the plaque was studied using OCT at the proximal cap, midpoint of the lesion, and the distal cap. Morphologic data studied included the intima-media thickness ratio, cross-sectional area of the plaque, and gray-scale median of the plaque.Results: A total of 140 patients who underwent lower extremity procedures for TASC D lesions of the SFA with OCT imaging were reviewed with a crossing rate of 69.0%. No significant differences were found between crossed and uncrossed lesions for intima-media thickness or cross-sectional area at the proximal cap, the midpoint, or the distal cap. A lower gray-scale median at the proximal cap was associated with the ability to cross the chronic SFA occlusion (P=0.05). Subgroup analysis stratified by smoking and calcium content also demonstrated that a lower gray-scale median at the proximal cap was associated with the ability to cross the chronic SFA occlusion (P=0.01 and P=0.04, respectively).Conclusions: Lower gray-scale median at the proximal cap of a chronic SFA occlusion calculated using OCT images was associated with the ability to successfully cross the lesion. Higher plaque gray-scale median is correlated with increased calcium, greater fibrous tissue, and signal-rich plaques. Gray-scale median in the proximal cap is useful marker to determine plaque composition and subsequent technical success for crossing chronic SFA occlusions. Further studies are needed to fully determine the utility of OCT images to predict successful endovascular revascularization of chronic SFA occlusions.

show abstract

Section: Patient Selectionmentioning

confidence: 99%

Optical coherence tomography and plaque morphology for revascularization of the superficial femoral artery

Hartwig¹,

Braet²,

Smith³

et al. 2021

Quant Imaging Med Surg

View full text Add to dashboard Cite

show abstract

Intraluminal crossing of infrainguinal SFA chronic total occlusions may offer patency superiority compared to subintimal crossing

Camazine,

Coorts,

Christian

et al. 2024

Vascular

View full text Add to dashboard Cite

Objectives Patency for chronic total occlusions (CTO) of the superficial femoral artery (SFA) after endovascular interventions traditionally demonstrate a low 1-year patency ranging from 40%–60%. The optical coherence tomography (OCT) catheter (Avinger Inc., Redwood City, CA) uses light-based technology imaging to cross Trans-Atlantic Inter-Society Consensus D (TASC D) lesions intraluminally with direct intra-arterial visualization. Insufficient data exist evaluating intraluminal crossing with OCT imaging compared with traditional subintimal techniques. We evaluated outcomes for TASC D lesions crossed intraluminally. Methods A retrospective analysis of patients with SFA TASC D lesions crossed intra-arterially with the OCT catheter imaging. Descriptive statistics evaluated patient characteristics which included patient demographics, Rutherford scores, ABIs, CTA information, lesion categorization, as well as runoff score. Patency at baseline, 30-day, 6-month, and 1-year outcomes were compared using t-tests. Cumulative patency rates were evaluated using Kaplan–Meier analysis. Results 101 patients underwent elective intervention for SFA TASC D lesions with the OCT catheter. The crossing rate was 78.2%, mean lesion length was 16.2 cm, and runoff at the tibial level was 2.2 patent vessels. Mean age and BMI were 64 years and 29 kg/m2, respectively. Patient characteristics are male (57%); Caucasian (90%); ever smoking (85%); hypertension (82%), hyperlipidemia (70%), and diabetes (46%). Pre-operative computed tomography demonstrated SFA lesions were predominantly eccentric (91%) with mild to moderate calcification (90%). All underwent PTA, 87% were stented (mean stent length: 186.1 mm), mean crossing time was 13.4 min. Pre-operative, 30-day, 6-month, and 1-year post-operative mean Rutherford–Becker scores were 4, 1, 1, and 1, respectively ( p < 0.0001). Mean pre-operative ABI was 0.49, compared to 0.84 at 30 days, 0.64 at 6 months, and 0.67 at 1 year ( p < .0001). Duplex demonstrated 6- and 12-month primary patency of 89% and 75%; primary-assisted patency was 94% and 84%. Conclusions The OCT imaging catheter successfully crossed long chronic total occlusions of the SFA using direct intra-arterial imaging. Compared to subintimal techniques, patients had high 1-year primary patency and prolonged symptom improvement with intraluminal crossing. These data suggest that intraluminal crossing of TASC D lesions may be superior to traditional subintimal crossing techniques.

show abstract

Application of deep oscillation therapy in the treatment of peripheral arterial diseases

Trybulski,

Biolik,

Kuczmik

et al. 2023

Med. perspekt.

View full text Add to dashboard Cite

Intermittent claudication is a common symptom of peripheral arterial disease, affecting up to 50% of patients over the age of 50, which is characterized by pain, discomfort, and cramping in the leg muscles during physical activity. Intermittent claudication is a common symptom of lower extremity arterial disease (LEAD), which significantly impacts patients’ quality of life and drives healthcare costs. Current treatments for intermittent claudication are often inadequate, leading to a need for more effective treatments. Developing new treatments is critical to improve outcomes for patients and address the public health implications of LEAD. This study’s aim was to present the impact of comprehensive physiotherapy, conducted independently, with the supervision of a physiotherapist, for 14 weeks, on a patient with intermittent claudication caused by peripheral arterial disease. The therapy included bicycle training in a form of physical therapy at home, combined with deep oscillation therapy. Deep oscillation therapy involved the use of an electrostatic field with a frequency of 5 to 250 Hz. The field was applied following the lymphatic drainage methodology. In the discussed case, a statistically significant and favourable increase in the measured variables was observed, such as the increase of bone-brachial index from 0.65 to 0.8, the increase of tissue perfusion, measured by laser Doppler flowmetry, from 12.3% to 61%, depending on the measurement site, and the increase in pain-free walking distance by 451%. TcPO2 measurement in the affected leg increased from 31 to 48 mmHg. The use of physical therapy at home combined with deep oscillation showed improvements in pain-free walking distance, Ankle Brachial Index, and other measures in patients with peripheral arterial disease. Deep oscillation therapy demonstrated potential analgesic effects but also raised concerns about possible nerve damage. The study indicated that physical therapy at home might serve as an alternative to supervised exercise therapy, but it had limitations like a small sample size and lack of direct comparisons.

show abstract

Five-year outcomes after revascularization of superficial femoral artery occlusion using Ocelot catheter

Cited by 3 publications

References 16 publications

Optical coherence tomography and plaque morphology for revascularization of the superficial femoral artery

Optical coherence tomography and plaque morphology for revascularization of the superficial femoral artery

Intraluminal crossing of infrainguinal SFA chronic total occlusions may offer patency superiority compared to subintimal crossing

Application of deep oscillation therapy in the treatment of peripheral arterial diseases

Contact Info

Product

Resources

About