Keywords:
Arteries / Aorta, Interventional vascular, Vascular, Catheter arteriography, CT-Angiography, Percutaneous, Angioplasty, Arterial access, Blood, Ischaemia / Infarction, Obstruction / Occlusion
Authors:
M. Tecame1, G. Cangiano2, E. Cavaglia3, M. Cirillo4, F. Maglione1, R. Grassi1; 1Napoli/IT, 2San Sebastiano al Vesuvio (NA)/IT, 3Napoli, NA/IT, 4Frattamaggiore, Naples/IT
DOI:
10.1594/ecr2013/C-1991
Methods and Materials
From 2009 to 2012 a total of 245 patients with obstructive injury of tibial vassels were treated in our operating unit.
A severe atheroma of pedidia artery and/or of the plantar artery associated with obstruction of metatarsal arterial arch was detected in 54 of them.
“Loop thechnique “ is an advanced technique used to recanalize tibial vassels,
used nowadays in III level pricipals references centers for the tratment of diabetic foot.
With this tecnique ,
we approach stenotic-obtructive lesions of pedidia and plantars artery ,
using the anatomic comunication between dorsal and plantar circle of the foot (“loop”).
In some cases infact,
it is almost impossibile to use an anterograde aproach due to the creation of subintimal way of the guidewire or the iatrogenic lesions that can occur during the recanalization ( ruptures or AV fistula).
The “Loop Tecnique” allows to attack this lesions in retrograde way ,obtaining at the same time,
the possibility of recanalize the tibial vassel and the trans-metatarsal artery (“loop”) ,
whence the digitals artery born.
This approach appeared feasible in about 50% of cases,
in the remaining cases can happend that the transit of guidewire was blocked due to extensive calcific infiltration of artery wall.
In this cases we used 0.014 guidewire (Pilot200 300cm –Abbott o PT2 300cm di BostonScientific) and low profile baloon overthewire (diameter 1.5-2 mm and 20-80 mm long - AmhirionDeep di Medtronic e Coyote ES di BS).
We present some our cases.