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DOI: 10.1055/s-0041-1735607
Infrapopliteal Artery Chronic Total Occlusion Crossing Techniques: An Overview for Endovascular Specialists
Critical limb ischemia (CLI) is on the rise due to diabetes and chronic kidney disease (CKD). It is the most severe form of peripheral artery disease with patients presenting with rest pain and/or tissue loss. The current reported amputation and mortality rates at 1 year are 20 to 25%.[1] CLI patients often present with multilevel disease and extensively calcified long chronic total occlusions (CTOs) in the infrapopliteal arteries. Successful CTO crossing can make the difference in terms of preventing amputation and salvaging the limb. Unfortunately, crossing CTOs often results in longer procedure times; higher radiation dose to the physician, staff, and patient; and an increased chance for arterial dissection and perforation. Depending on an operator's experience, the failure rate of CTO crossing can be 20% or greater. Given the importance of a successful revascularization in this high-risk patient population, it is vital that endovascular specialists become experts at below-the-knee CTO crossing using the various techniques available today.
Disclosures
A.J.R. has no disclosures.
S.T. is a course faculty, speaker, and consultant for Bard Peripheral Vascular Inc., Abbott Vascular, Cardiovascular Systems Inc., and Terumo Interventional Systems.
Publication History
Article published online:
07 October 2021
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