［2022/10/18] Echo-guided (EVUSG) wiring for CTOs in SFAs has shown the potential to lead to high patency rates by achieving optimal vessel preparation and subsequent self-expandable stent placement, Dr.Yasunari Sakamoto of Osaki Hospital Tokyo Heart Center and colleagues reported in the online edition of the Journal of Invasive Cardiology.
Echo-guided Wiring in EVT for SFA CTOs
The investigators reported that from April 2007 to January 2019, 202 patients (239 limbs) with symptomatic peripheral artery disease who underwent successful EVT and implantation of a self-expandable nitinol stent for the CTO of the SFA at Saiseikai Yokohama City Eastern Hospital The patients were divided into 60 patients (65 limbs) in the EVUSG group and 142 patients (174 limbs) in the conventional contrast-guided group according to the strategy used for CTO wiring, and the effects of EVUSG on vessel preparation and patency were investigated.
The balloon diameter at first dilation immediately after successful wire passage was not significantly different between the EVUSG and contrast groups (3.7 mm vs. 3.8 mm: p=0.17). The incidence of severe dissection after the first balloon dilation was significantly lower in the EVUSG group (43%) than the contrast group (79%) (p<0.001). 3-year primary patency was 84.5% in the EVUSG group and 68.4% in the contrast group (p<0.001).
Dr.Sakamoto and colleagues summarize, "EVUSG for SFA CTOs improves visibility within the plaque, allowing passage of the wire into the central axis of the vessel and achieving optimal vessel preparation, defined as balloon dilation without severe dissection, and subsequent placement of a self-expanding stent may result in better patency."
Sakamoto Y et al, J Invasive Cardiol. 2022; 34: in press
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