An Effective Guidewire Looping Technique for the Recanalization of Occlusive Segments of Infrapopliteal Vessels.
10.3348/kjr.2010.11.4.441
- Author:
Jian bo WANG
1
;
Jun gong ZHAO
;
Ming hua LI
;
Yue qi ZHU
;
Jue WANG
;
Pei lei ZHANG
Author Information
1. Institute of Diagnostic and Interventional Radiology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, China. zhao.jungong@163.com
- Publication Type:Original Article
- Keywords:
Infrapopliteal arteries;
Loop technique;
Limb ischemia;
Angioplasty
- MeSH:
Aged;
Aged, 80 and over;
Angioplasty/*methods;
Ankle Brachial Index;
Arterial Occlusive Diseases/*surgery;
Female;
Follow-Up Studies;
Foot/blood supply/surgery;
Humans;
*Magnetic Resonance Angiography;
Male;
Middle Aged;
*Popliteal Artery;
Postoperative Complications;
Treatment Outcome
- From:Korean Journal of Radiology
2010;11(4):441-448
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To determine the efficacy, safety and primary follow-up results of a guidewire looping technique for the treatment of infrapopliteal arteries. MATERIALS AND METHODS: From October 2006 to May 2008, an intraluminal angioplasty of the infrapopliteal arteries was attempted in 200 consecutive patients. Altogether, 417 infrapopliteal lesions, with lengths varying from 2 cm to 32 cm, were treated as part of this study, including 305 lesions in the anterior tibial arteries, 89 in the posterior tibial arteries, and 23 in the peroneal arteries. The 'U'-shaped guidewire technique was attempted in 393 lesions from 361 limbs. The tip of a hydrophilic 0.035-inch guidewire was formed into a 'U' shape with the aid of a 4-Fr catheter and collateral branch vessel to recanalize the completely occluded long segment lesions. RESULTS: A successful angioplasty with at least one artery recanalized directly to the malleolar or dorsal foot was achieved in 322 limbs (89%). The looping technique had a success rate of 90% (352 of 393 lesions). After the procedure, the rest pain was relieved in 58 of 69 patients, while 207 of 245 limbs (85%) showed improvement for intermittent claudication. Complete wound healing was noted in 21 of 54 patients, while 20 of 54 patients showed an improvement in the wound size or depth. A total of 38 major immediate procedure-related complications were noted, including retroperitoneal hematoma, distal emboli, and vessel rupture. CONCLUSION: The results of this study suggests that the guidewire looping technique is a safe and effective method for the recanalization of the occluded lesions in infrapopliteal vessels.
