2 / 17
Vascular Surgery 2019
Journal of Vascular and Endovascular Therapy
ISSN: 2573-4482
Page 58
March 28-29, 2019
Rome, Italy
Vascular Surgery
4
th
Edition of World Congress & Exhibition on
Huei-Lung Liang, J Vasc Endovasc Therapy 2019, Volume 4
DOI: 10.21767/2573-4482-C1-006
Use of a Colapinto TIPS needle under cone-beam CT
guidance for re-entry in subintimal recanalization of chronic
iliac artery occlusion
Huei-Lung Liang
VGHKS, Taiwan
Purpose:
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.
Methods:
Patients with chronic iliac artery occlusion
(including Leriche syndrome) with earlier failed attempts
at conventional percutaneous recanalizationby guidewire
and catheter-based techniques during the past 8 years
were retrospectively reviewed. 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 if commercially available
outback catheter failed or unaffordable. The puncture
was directed under two orthogonal fluoroscopic views
or rotational angiography cone-beam CT guidance to re-
enter the abdominal aorta. Bare metallic stents of 8-10
mm in diameter were deployed and followed by balloon
dilation.
Results:
Twelve patients (11 male; median age, 75 years)
were included in our investigation. The average occlusion
length was 12.2 cm (range, 4-20 cm). Successful re-
entry was achieved in all patients without procedure-
related complications. The ankle e brachial index (ABI)
values increased from 0.38-0.79 to 0.75-1.28 after the
procedure. Imaging follow-up (>6 months) was available
in eight 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-beamCT image guidance, appears to be safe
and effective to re-enter the true lumen in a subintimal
angioplasty for a dif cult chronic total iliac occlusion.
Recent Publications
1. Mangialardi N, Ronchey S, Serrao E et al. (2017)
Endovascular management of total juxtarenal
aortic occlusive disease in high-risk patients:
technical considerations and clinical outcome.
J Cardiovasc Surg 58:422-430.
2. Kitrou P, Parthipun A, Diamantopoulos A et
al. (2015) Targeted true lumen re-entry with
the outback catheter: accuracy, success,
and complications in 100 peripheral chronic
total occlusions and systematic review of the
literature. J Endovasc Ther 22:538-545.
3. Kim T H, Ahn J H and Kim D H (2013) A
successful retrograde re-entry at aorta using
the outback LTDcatheter for a bilateral common
iliac artery occlusion. Catheter Cardiovasc
Interv 81:E250-254.
4. Liang G Z and Zhang F X (2013) Novel devices
and specialized techniques in recanalization
of peripheral artery chronic total occlusions