Long‐term outcomes after re‐entry device use for recanalization of common iliac artery chronic total occlusions

Kokkinidis, Damianos G.; Alvandi, Bejan; Cotter, Ryan; Hossain, Prio; Foley, T. Raymond; Singh, Gagan D.; Waldo, Stephen W.; Laird, John R.

doi:10.1002/ccd.27583

Cited by 14 publications

(7 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Comparing re-entry devices (Pioneer and Outback) with standard crossing techniques; a retrospective study assessing long-term outcomes of common iliac arteries recanalization demonstrated similar target lesion revascularisation, major adverse limb events rates as well as complication rates. In this aforementioned study, Pioneer was used more often than Outback as it is less technically challenging (Kokkinidis et al, 2018 ). However, we cannot confidently conclude the superiority of one method, as there are no randomised control studies or prospective data collection, comparing the use of Pioneer with using crossing wires alone.…”

Section: Discussionmentioning

confidence: 99%

Use and effectiveness of Pioneer re-entry device for subintimal true lumen re-entry: single-centre data and a review of the literature

et al. 2021

View full text Add to dashboard Cite

Introduction During subintimal angioplasty (SIA), it is not always possible to re-enter the vessel lumen due to a variety of factors. Recanalization using hydrophilic wires and catheters alone, apart from its potential technical failure, is also limited by minimal control over the re-entry point. This is frequently well beyond the point of occlusion, thus often compromising important collaterals. In order to bypass the obstruction and attain controlled re-entry into the lumen of the diseased vessel, a re-entry device (RED) may be required. This paper assesses our centre’s experience with the safety and efficacy of the Pioneer re-entry system and systematically reviews the pertinent literature. Method A single centre retrospective study of subintimal angioplasty involving the use of the Pioneer Plus intravascular guided reentry catheter was performed. Patient demographics including age, gender, risk factors, comorbidities clinical indication and complications were recorded. Lesion characteristics, including location and severity of calcification were also assessed. A systematic literature review of all reported studies where the Pioneer RED was used for iliac and lower limb revascularization was conducted by 2 of the authors using the PubMed (MEDLINE) and EMBASE databases. Results The study comprised 30 cases. Technical success was 97%. A small, quickly resolved extravasation was the only device related complication. These results are in line with the systematic review which identified 16 studies using the Pioneer RED, reporting a technical success rate of 87.4–100% (median = 100%) and complication rate of 0–25.8% (median = 0%). However, due to heterogeneity in definitions of technical success, data was not pooled.

show abstract

Section: Discussionmentioning

confidence: 99%

Use and effectiveness of Pioneer re-entry device for subintimal true lumen re-entry: single-centre data and a review of the literature

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In 2018, Kokkinidis et al ( 26 ) also published the first paper comparing long-term outcomes after PIER of CTOs of the AT with or without RED and they found non-significant differences among the two groups, as target lesion revascularization rate at 1 and 5 years was 11 and 29% with RED and 9 and 29% with traditional PIER, with a post-angioplasty stenting rate of 82% after RED and 87% after traditional PIER.…”

Section: Discussionmentioning

confidence: 99%

The Use of Re-entry Devices in Aortoiliac Occlusive Disease

Pescatori

Tacher

Kobeiter

2020

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Endovascular approach is the first-choice treatment in patients suffering from aortoiliac occlusions. Nevertheless, standard endoluminal revascularization fails in treating occlusions in about 20% ( 1 ) of cases. Thus, subintimal revascularization can be a solution, but it fails in 25% ( 2 ) of cases as well. In the last decades, different devices have been created, in order to ease the cross back into the true lumen, when standard subintimal revascularization does not work or risks to occlude important collateral vessels. Herein, we revise the currently available re-entry devices and their application in the aortoiliac occlusive pathology.

show abstract

“…In the last decade, open surgery has been the standard method for severe occlusive lesions, but recent advances in interventional techniques and devices allow percutaneous revascularization and present comparable patency rates during long follow-up for patients with iliac occlusive disease regardless of lesion complexity. As a result, this endovascular-first concept has been a regular concept in the majority of institutions worldwide [2,3].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and long-term outcomes of different crossing strategies for the endovascular treatment of iliac artery chronic Total occlusions

Zhang

Niu

et al. 2020

BMC Cardiovasc Disord

View full text Add to dashboard Cite

Background The iliac occlusive disease is usually treated with endovascular procedures in recent years. The effectiveness of different crossing approaches for these occlusions is not precisely known. We performed a retrospective study to explore the optimal crossing approach (antegrade versus retrograde) for iliac artery chronic total occlusions (CTOs) and to examine the long-term outcomes. Materials and methods We performed a study on 107 patients (116 iliac occlusive lesions, mean age 64.0 ± 11.1, 88 men) who underwent an iliac CTO endovascular intervention attempted with the use of both crossing strategies but were managed with one final crossing approach between August 2012 and August 2018. Baseline data, procedural characteristics, and outcomes were described. A Cox proportional hazard model and Kaplan-Meier method were developed to assess the differences in the two crossing approaches in terms of the 1-year and 5-year primary patency rates, target lesion revascularization (TLR) and major adverse limb events (MALEs). Results Common iliac artery (CIA) lesions were more likely to be crossed successfully in the retrograde direction (6.8% for antegrade vs. 20.9% for retrograde, p = 0.005), while lesions in the CIA/ external iliac artery (EIA) were more prone to be crossed successfully in the antegrade direction (58.9% for antegrade vs. 39.5% for retrograde, p = 0.016). There were no significant differences in the crossing approach for EIA lesions between the two groups. The two crossing approaches were associated with similar estimates of 1- and 5-year primary patency, TLR and MALE rates. Conclusion The antegrade approach was associated with a higher rate of successful crossing in CIA/EIA CTO lesions, while the CIA-only CTOs were more likely to be crossed successfully with the retrograde approach.

show abstract

Long‐term outcomes after re‐entry device use for recanalization of common iliac artery chronic total occlusions

Abstract: This retrospective analysis found that recanalization of CIA occlusions using a RED is safe and is associated with long-term clinical outcomes similar to that of standard crossing techniques.

Cited by 14 publications

References 34 publications

Use and effectiveness of Pioneer re-entry device for subintimal true lumen re-entry: single-centre data and a review of the literature

Use and effectiveness of Pioneer re-entry device for subintimal true lumen re-entry: single-centre data and a review of the literature

The Use of Re-entry Devices in Aortoiliac Occlusive Disease

Effectiveness and long-term outcomes of different crossing strategies for the endovascular treatment of iliac artery chronic Total occlusions

Contact Info

Product

Resources

About