Heavily calcified chronic total occlusion of common iliac artery successfully treated with Tornus microcatheter and rotational atherectomy

Abstract

A 58-year-old man who required long-term hemodialysis was referred to our institution for the management of life-limiting intermittent claudication of the right lower extremity. The diagnostic arteriography demonstrated heavily calcified chronic total occlusion in the right common iliac artery. The lesion was successfully treated with the combination of a Tornus microcatheter (Asahi Intecc, Aichi, Japan) and rotational atherectomy. We describe in this article a niche application of the Tornus microcatheter and the effect of the combination technique of it with rotational atherectomy in peripheral interventions.

Combined Use of Excimer Laser and High-Speed Rotational Atherectomy to Overcome a Severely Calcified Lesion in Endovascular Therapy

“…Hara et al discussed the application of RA in heavily calcified CTO of the common iliac artery in a long-term hemodialysis patient. They had difficulties in passing the conventional microcatheter and used a Tornus microcatheter (ASAHI Intecc) instead [14]. The disadvantage of RA is the need for a dedicated 0.009-inch wire, which is cumbersome to control as a bare wire and requires microcatheter crossing.…”

Transpedal access after failed anterograde recanalization of complex below‐the‐knee and femoropoliteal occlusions in critical limb ischemia

“…Beside the GW technology, two kinds of devices were developed: support devices to increase the penetration power and to increase the steerability of the GWs and re‐entry devices. First, support devices such as Tornus (Asahi Co) gives adequate support for penetrating the hard fibrous cap. In our practice anterograde support was routinely provided by 45 cm antegrade 5F sheath and 5F vertebral catheter (Cook) in the FP segment and low profile OTW balloon in the BTK segment.…”

Application of rotational atherectomy for a calcified superficial femoral artery lesion

“…There are some reports of atherectomy employed for heavily calcified lesions and/or undilatable lesions [14][15][16][17]. In this case, the SFA lesion was seemingly simple but the presence of bypass graft and severe calcification of approach site and arteries to target lesion made more problematic in terms of endovascular procedure.…”

“…However, in recent years, a variety of new techniques and devices have become available [7][8][9][10][11][12][13]. The usefulness of high speed rotational atherectomy for calcified lesions is well known and can also be applied to peripheral arteries [14][15][16][17][18]. Atherectomy of the calcified lesion by Rotablator (Boston Scientific, Natick, MA, USA) can facilitate easy balloon crossing, balloon dilatation, and subsequent stenting.…”