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首页> 外文期刊>Vascular and endovascular surgery >Endovascular Treatment of Long Superficial Femoral Artery-Chronic Total Occlusions Using the Gogo Catheter With IVUS Via a Popliteal Puncture Method Is Effective, Safe, and Useful
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Endovascular Treatment of Long Superficial Femoral Artery-Chronic Total Occlusions Using the Gogo Catheter With IVUS Via a Popliteal Puncture Method Is Effective, Safe, and Useful

机译：使用Popliteal穿刺方法使用Gogo导管使用Gogo导管的长表面股动脉 - 慢性总闭塞的血管内治疗是有效的，安全的，有用的

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Objectives: We aimed to investigate the usefulness of inserting a 6Fr sheath guided by duplex ultrasonography via a popliteal artery puncture. We also aimed to demonstrate endoluminal tracking using a retrograde approach using the Gogo catheter with intravascular ultrasound (IVUS). Background: The bidirectional approach is useful for increasing the success rate of the procedure for long superficial femoral artery-chronic total occlusions (SFA-CTOs). However, this procedure becomes somewhat complicated. Since the proximal blood vessel diameter is clearly larger than the distal end of the CTO and the body surface duplex guide can also be used in the proximal part, it is easier to introduce a retrograde guidewire (GW) into the proximal end. Methods: We performed endovascular treatment for long SFA-CTOs with a Gogo catheter + IVUS guide in 31 consecutive cases (male 20/female 11; mean age, 75.6 +/- 7.6) from May 2017 to November 2018. We advanced the IVUS until the true lumen could be confirmed and advanced the Gogo catheter toward the IVUS for reinforcement. We attempted to approach the long CTO by repeating this procedure. We named this procedure the GIP method (GIP: Gogo catheter with IVUS via a popliteal puncture). Hemostasis of the popliteal artery was achieved using a commercially available compression hemostatic kit (Tometa-kun, XEMEX, Japan). Results: Successful revascularization was achieved in all cases (in 2 cases, a femoral artery puncture was added, and a bidirectional approach was used, and in 1 case, a CROSSER system was used). On average, the fluoroscopy time was 42.2 +/- 30.4 minutes, radiation dose 93.7 +/- 78.7 mGy, and amount of contrast medium used 15.0 +/- 9.6 mL. The procedure time was defined as from the start of the popliteal artery puncture to the time the GW passed through the CTO lesion, including the posture transformation time from prone to the supine position. The procedure time was 42.1 +/- 40.2 minutes. There were no major adverse events or other major complications, such as a distal embolism, rupture of the CTO lesion, arteriovenous fistula, or major hematoma requiring a transfusion or surgical treatment. Only 2 small hematomas occurred at the popliteal artery puncture site. The patients were treated conservatively and were discharged as usual. Conclusions: Endovascular treatment of long SFA-CTOs via the popliteal approach was effective and safe. Using the GIP method to address long SFA-CTOs is recommended.
机译：目的：我们旨在探讨通过Popliteal动脉穿刺插入双链超声检查的6FR鞘的有用性。我们还旨在使用具有血管内超声（IVUS）的Gogo导管的逆行方法来展示内泌型跟踪。背景：双向方法可用于提高长表面股动脉 - 慢性总闭塞（SFA-CTO）的程序的成功率。但是，这个程序变得有些复杂。由于近端血管直径明显大于CTO的远端，并且体表面双工引导件也可以在近端部分中使用，因此更容易将逆行导丝（GW）引入近端。方法：在2017年5月至2018年5月，我们在连续31例（男性20 /女11;平均年龄，75.6 +/- 7.6）中对长SFA-CTO进行血管内治疗。从2017年5月到2018年11月，我们向2017年11月前进了IVUS真正的腔可以确认并向IVUS进行高级Gogo导管进行加固。我们试图通过重复此程序来接近长期CTO。我们将此过程命名为GIP方法（GIP：Gogo导管通过Popliteal穿刺患者）。使用市售的压缩止血套件（Tometa-Kun，Xemex，Japan）实现了Popliteal动脉的止血。结果：在所有情况下实现了成功的血运重建（在2例中，加入股动脉穿刺，使用双向方法，在1例中，使用了一系列交叉系统）。平均而言，透视时间为42.2 +/- 30.4分钟，辐射剂量93.7 +/- 78.7变化，以及使用15.0 +/- 9.6ml的造影剂量。过程时间被定义为从Popliteal动脉刺穿到GW通过CTO病变的时间，包括从容易到仰卧位的姿势转换时间。程序时间为42.1 +/- 40.2分钟。没有主要的不良事件或其他主要并发症，例如远端栓塞，CTO病变破裂，动静脉瘘或需要输血或手术治疗的主要血肿。 Popliteal动脉穿刺部位仅发生2个小血肿。患者保守治疗，并像往常一样排出。结论：通过Popliteal方法对长SFA-CTO的血管内治疗是有效和安全的。建议使用GIP方法解决长SFA-CTOS。

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