PDF(Pubmed)
Abstract：
BACKGROUND: The optimal endovascular treatment (EVT) for chronic total occlusion (CTO) lesions in patients with peripheral artery disease (PAD) has remained unestablished. We encountered a patient with PAD in whom CTO was successfully treated using a novel technique that involved intravascular ultrasound (IVUS) and angled guiding catheter: IVUS Preceding with Angled guiDing catheter (I-PAD) technique.
METHODS: A 74-year-old male presented with intermittent claudication attributed to CTO of the right external iliac artery. EVT was performed via the right common femoral artery. We retrogradely advanced the I-PAD system (i.e. partially extending the IVUS transducer portion from the tip of the angled guiding catheter) in the CTO lesion under the real-time guidance of IVUS imaging. We successfully traversed the CTO lesion without the use of a guidewire in approximately three minutes. The procedure concluded successfully without any procedure-related complications, following optimal stenting.
CONCLUSIONS: The I-PAD might be an effective technique to accurately, quickly, and safely pass through CTO lesions.
METHODS: A 74-year-old male presented with intermittent claudication attributed to CTO of the right external iliac artery. EVT was performed via the right common femoral artery. We retrogradely advanced the I-PAD system (i.e. partially extending the IVUS transducer portion from the tip of the angled guiding catheter) in the CTO lesion under the real-time guidance of IVUS imaging. We successfully traversed the CTO lesion without the use of a guidewire in approximately three minutes. The procedure concluded successfully without any procedure-related complications, following optimal stenting.
CONCLUSIONS: The I-PAD might be an effective technique to accurately, quickly, and safely pass through CTO lesions.
摘要：
背景：外周动脉疾病（PAD）患者慢性完全闭塞（CTO）病变的最佳血管内治疗（EVT）仍未建立。我们遇到了一名PAD患者，其中CTO使用了一种涉及血管内超声（IVUS）和倾斜引导导管的新技术成功治疗：IVUS先于倾斜的guiding导管（I-PAD）技术。
方法：一名74岁男性患者，表现为右髂外动脉CTO所致间歇性跛行。通过右股总动脉进行EVT。我们在IVUS成像的实时引导下，在CTO病变中逆行推进了I-PAD系统（即从倾斜引导导管的尖端部分延伸IVUS换能器部分）。我们在大约三分钟内成功地穿越了CTO病变，而无需使用导丝。手术成功结束，没有任何手术相关的并发症，在最佳支架置入后。
结论：I-PAD可能是一种有效的技术，快,并安全通过CTO病变.
方法：一名74岁男性患者，表现为右髂外动脉CTO所致间歇性跛行。通过右股总动脉进行EVT。我们在IVUS成像的实时引导下，在CTO病变中逆行推进了I-PAD系统（即从倾斜引导导管的尖端部分延伸IVUS换能器部分）。我们在大约三分钟内成功地穿越了CTO病变，而无需使用导丝。手术成功结束，没有任何手术相关的并发症，在最佳支架置入后。
结论：I-PAD可能是一种有效的技术，快,并安全通过CTO病变.
