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題名 | The Use of a Colapinto TIPS Needle under Cone-beam Computed Tomography Guidance for True Lumen Re-entry in Subintimal Recanalization of Chronic Iliac Artery Occlusion= |
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作者 | Liang, Huei-lung; Li, Ming-feng; Chiang, Chia-ling; Chen, Matt Chiung-yu; Wu, Chieh-jen; Pan, Huay-ben; Chen, Matt Chiung-yu; Pan, Huay-ben; Wu, Chieh-jen; Chiang, Chia-ling; Li, Ming-feng; Liang, Huei-lung; |
期刊 | Journal of the Chinese Medical Association |
出版日期 | 20170600 |
卷期 | 80:6 2017.06[民106.06] |
頁次 | 頁371-375 |
分類號 | 415.384 |
語文 | eng |
關鍵詞 | Angioplasty; Cone-beam computed tomography; Iliac artery occlusion; Subintimal angioplasty; True lumen re-entry; |
英文摘要 | Background: To report the technique and clinical outcome of subintimal re-entry in chronic iliac artery occlusion by using a Colapinto transjugular intrahepatic portosystemic shunt (TIPS) needle under rotational angiography (cone-beam computed tomography; CT) imaging guidance. Methods: Patients with chronic iliac artery occlusion with earlier failed attempts at conventional percutaneous recanalization during the past 5 years were enrolled in our study. In these patients, an ipsilateral femoral access route was routinely utilized in a retrograde fashion. A Colapinto TIPS Needle was used to aid the true lumen re-entry after failed conventional intraluminal or subintimal guidewire and catheter-based techniques. The puncture was directed under rotational angiography cone-beam CT guidance to re-enter the abdominal aorta. Bare metallic stents 8e10 mm in diameter were deployed in the common iliac artery, and followed by balloon dilation. Results: Ten patients (9 male; median age, 75 years) were included in our investigation. The average occlusion length was 10.2 cm (range, 4e15 cm). According to the Trans-Atlantic Inter-Society Consensus (TASC) II classification, there were five patients each with Class B and D lesions. Successful re-entry was achieved in all patients without procedure-related complications. The ankleebrachial index (ABI) values increased from 0.38e0.79 to 0.75e1.28 after the procedure. Imaging follow-up (> 6 months) was available in six patients with patency of all stented iliac artery. Thereafter, no complaints of recurrent clinical symptoms occurred during the follow-up period. Conclusion: The use of Colapinto TIPS needle, especially under cone-beam CT image guidance, appears to be safe and effective to re-enter the true lumen in a subintimal angioplasty for a difficult chronic total iliac occlusion. |
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