Novel use of ultrasound guidance for recanalization of iliac, femoral, and popliteal arteries

Kawasaki, Daizo; Tsujino, Takeshi; Fujii, Kenichi; Masutani, Motomaru; Ohyanagi, Mitsumasa; Masuyama, Tohru

doi:10.1002/ccd.21503

Cited by 44 publications

(44 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previously proposed projects demonstrated the real potential of performing endovascular peripheral intervention without fluoroscopy or contrast in a practical, user-friendly way with the currently available technology [1][2][3][4]. There have been reports in the literature about the use of ultrasound guidance to minimize contrast and radiation use [2][3][4].…”

Section: Discussionmentioning

confidence: 98%

The fluoro-less and contrast-less peripheral endovascular intervention: Halfway there

Ephrem

Garikipati

Hanson

2016

Cardiovascular Revascularization Medicine

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 98%

The fluoro-less and contrast-less peripheral endovascular intervention: Halfway there

Ephrem

Garikipati

Hanson

2016

Cardiovascular Revascularization Medicine

View full text Add to dashboard Cite

“…We have already reported that this IVUS catheter can be used with the 0.018-inch guidewire, although it was originally designed for a 0.014-inch guidewire. 5 When the IVUS showed that the tip of the guidewire was located in the endoluminal space of the occluded vessel, we advanced the guidewire further. When the IVUS …”

Section: Treatmentmentioning

confidence: 99%

“…When the guidewire and IVUS catheter could not be advanced into the occlusive lesion because of insufficient back-up force or severe calcification, we advanced a straight, peripheral, 6Fr guide catheter (Mach 1™, Boston Scientific, Natic, MA, USA) after dilatation of the occluded endoluminal space with a 3.0-mm balloon. 5 In the case of iliac and/or femoral stenotic lesions, we advanced a floppy guidewire under IVUS guidance through the stenotic lesion.…”

Section: Endovascular Therapy Without Contrast Mediamentioning

confidence: 99%

“…As previously reported by our group, this IVUS system can be used not only to identify the exact location and severity of the occlusive lesion, but also to precisely measure the extent of the lesion. 5 Standard X-ray guidance of balloon angioplasty provides faster advancement of guidewires and catheters during the intervention because the fluoroscopic image encompasses a wider field. IVUS guidance, with its known limited cross-sectional view, requires slower advancement of guidewires and the IVUS catheter, because of the uncertain visualization and position of the guidewires, at least during the learning curve period.…”

Section: Ivus-guided Evtmentioning

confidence: 99%

See 1 more Smart Citation

Preprocedural Evaluation and Endovascular Treatment of Iliofemoral Artery Disease Without Contrast Media for Patients With Pre-Existing Renal Insufficiency

Kawasaki

Fujii

Fukunaga

et al. 2011

Circ J

Self Cite

View full text Add to dashboard Cite

“…In this issue, Kawasaki and colleagues [10] report their experience assuring an intraluminal guidewire trajectory using adjunctive intravascular ultrasound (IVUS) imaging. They take advantage of a new low-profile hydrophilic 0.018*Prime; guidewire (not available in the United States) and generous tolerances apparently afforded by a 0.014*Prime;-rated commercial phased-array IVUS catheter.…”

mentioning

confidence: 99%

Recanalization of chronic peripheral artery occlusions: Moving forward by looking sideways

Lederman

2008

Cathet Cardio Intervent

View full text Add to dashboard Cite

Chronic peripheral artery occlusions can be challenging to recanalize. Two general strategies are prevalent, and neither is necessarily under the direct control of the operator. In the classic (and in my opinion favored) "centriluminal" technique, the operator attempts to direct guidewires in tandem with controlling catheters to traverse the occlusive atheroma while remaining within the confines of the arterial media. The second technique, inaptly called the "subintimal" approach [1,2], in some ways resembles a controlled perforation in both ease and (in my opinion) attractiveness. The guidewire traverses the occlusion by entering a shallow subadventitial plane using a large guidewire "knuckle" and afterwards can reenter the patent distal arterial lumen. In both techniques, conventional imaging usually provides few robust cues about the true course of the guidewire within the occlusion.In this issue, Kawasaki and colleagues [10] report their experience assuring an intraluminal guidewire trajectory using adjunctive intravascular ultrasound (IVUS) imaging. They take advantage of a new low-profile hydrophilic 0.018*Prime; guidewire (not available in the United States) and generous tolerances apparently afforded by a 0.014*Prime;-rated commercial phased-array IVUS catheter. They use the IVUS catheter as their support device. In the Kawasaki centriluminal approach, the side-looking IVUS device is advanced over the guide-wire step-by-step to assure an appropriate intraluminal position. When the position appears subadventitial, both the IVUS and the guidewire are retracted and redirected before advancing again. Unfortunately, this technique identifies an unsuitable position only in retrospect, since the IVUS device is oriented not forwards but sideways, and the ultrasound transducer is positioned at least 10-15 mm proximal to the guidewire tip.Such retrospective image guidance is analogous to driving through a tunnel watching only the side windows, hoping the front of the car passes or crumples safely. Fortunately in the Kawasaki experience, peripheral artery occlusions were fairly forgiving, in that short distances of unfavorable subadventitial axial advancement of the devices appeared well-tolerated. The authors report a significantly improved success rate and reduced iodinated radiocontrast exposure, although not procedure time or radiation exposure.Other adjuncts are available to enhance conventional radiographic guidance of iliofemoral CTO recanalization, including optical interferometry More promising future technologies might include forward-looking intravascular ultrasound [7,8] or perhaps better, conducting the entire recanalization procedure under real-time MRI guidance [9] to assure wholly intraluminal guidewire traversal.

show abstract

Novel use of ultrasound guidance for recanalization of iliac, femoral, and popliteal arteries

Abstract: The IVUS-guided endovascular therapy for CTO using Treasure 12 guidewire is feasible and safe, minimizes contrast material, and has a high initial technical success rate.

Cited by 44 publications

References 17 publications

The fluoro-less and contrast-less peripheral endovascular intervention: Halfway there

The fluoro-less and contrast-less peripheral endovascular intervention: Halfway there

Preprocedural Evaluation and Endovascular Treatment of Iliofemoral Artery Disease Without Contrast Media for Patients With Pre-Existing Renal Insufficiency

Recanalization of chronic peripheral artery occlusions: Moving forward by looking sideways

Contact Info

Product

Resources

About