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KMID : 0880420100110040441
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Korean Journal of Radiology
2010 Volume.11 No. 4 p.441 ~ p.448
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An Effective Guidewire Looping Technique for the Recanalization of Occlusive Segments of Infrapopliteal Vessels
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Wang Jian-Bo
Zhao Jun-Gong
Li Ming-Hua
Zhu Yue-Qi
Wang Jue
Zhang Pei-Lei
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Abstract
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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.
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KEYWORD
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Infrapopliteal arteries, Loop technique, Limb ischemia, Angioplasty
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