Recanalization of popliteal and infrapopliteal chronic total occlusions using viance and crossboss crossing catheters

A multicenter experience from the XLPAD registry

Salil Sethi, Atif Mohammad, S. Hinan Ahmed, Samir Germanwala, Karan Sarode, Carolina Ortiz-Lopez, Subhash Banerjee, Anand Prasad

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background. Chronic total occlusions (CTOs) are reported in up to 40% of patients with symptomatic peripheral arterial disease. The Viance Crossing catheter (Covidien) and the CrossBoss catheter (Boston Scientific) are novel devices that facilitate either true lumen or subintimal navigation across CTOs. The purpose of this study was to examine the acute procedural success of these devices for popliteal and below-the-knee (BTK) CTOs. Methods. Clinical and procedural outcome data between Sept 2010 and October 2013 were analyzed from the ongoing multicenter XLPAD registry. Technical success was defined as true lumen passage of the catheter, while procedural success was defined as successful vessel revascularization inclusive of subintimal passage and reentry. Results. Twenty-nine patients underwent 31 procedures, in which 37 lesions were treated with the Viance and CrossBoss catheters. Mean age of the group was 69.1 ± 10.7 years and 26 patients were male (90%). All patients (100%) had hypertension, 62% were diabetic, and 48% were active smokers. Critical limb ischemia was the indication for the procedure in 58% of cases; mean Rutherford class was 4.2 ± 1.2 for the entire cohort. Target CTOs included 14 anterior tibial, 9 posterior tibial, 5 peroneal, 1 tibio-peroneal trunk, and 8 popliteal artery lesions. Mean lesion length was 81 ± 64 mm; 15 lesions (41%) were severely calcified. True lumen passage was obtained in 24 lesions (65% technical success). Subintimal entry was achieved in 5 lesions (14%). Procedural success was achieved in 26 lesions (70%). Procedural failure was related to longer lesion length (P<.001), and mean length of failed lesions was 136 ± 65 mm. Conclusion. Viance and CrossBoss catheters were associated with an overall 70% procedural success with predominantly true lumen crossing in a BTK-CTO cohort. CTO length remains an important determinant of device success.

Original languageEnglish (US)
Pages (from-to)2-7
Number of pages6
JournalJournal of Invasive Cardiology
Volume27
Issue number1
StatePublished - Jan 1 2015

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Registries
Catheters
Equipment and Supplies
Knee
Popliteal Artery
Peripheral Arterial Disease
Ischemia
Extremities
Age Groups
Hypertension

Keywords

  • Chronic total occlusion
  • Peripheral arterial disease
  • Viance crossing catheter

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Recanalization of popliteal and infrapopliteal chronic total occlusions using viance and crossboss crossing catheters : A multicenter experience from the XLPAD registry. / Sethi, Salil; Mohammad, Atif; Ahmed, S. Hinan; Germanwala, Samir; Sarode, Karan; Ortiz-Lopez, Carolina; Banerjee, Subhash; Prasad, Anand.

In: Journal of Invasive Cardiology, Vol. 27, No. 1, 01.01.2015, p. 2-7.

Research output: Contribution to journalArticle

Sethi, Salil ; Mohammad, Atif ; Ahmed, S. Hinan ; Germanwala, Samir ; Sarode, Karan ; Ortiz-Lopez, Carolina ; Banerjee, Subhash ; Prasad, Anand. / Recanalization of popliteal and infrapopliteal chronic total occlusions using viance and crossboss crossing catheters : A multicenter experience from the XLPAD registry. In: Journal of Invasive Cardiology. 2015 ; Vol. 27, No. 1. pp. 2-7.
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abstract = "Background. Chronic total occlusions (CTOs) are reported in up to 40{\%} of patients with symptomatic peripheral arterial disease. The Viance Crossing catheter (Covidien) and the CrossBoss catheter (Boston Scientific) are novel devices that facilitate either true lumen or subintimal navigation across CTOs. The purpose of this study was to examine the acute procedural success of these devices for popliteal and below-the-knee (BTK) CTOs. Methods. Clinical and procedural outcome data between Sept 2010 and October 2013 were analyzed from the ongoing multicenter XLPAD registry. Technical success was defined as true lumen passage of the catheter, while procedural success was defined as successful vessel revascularization inclusive of subintimal passage and reentry. Results. Twenty-nine patients underwent 31 procedures, in which 37 lesions were treated with the Viance and CrossBoss catheters. Mean age of the group was 69.1 ± 10.7 years and 26 patients were male (90{\%}). All patients (100{\%}) had hypertension, 62{\%} were diabetic, and 48{\%} were active smokers. Critical limb ischemia was the indication for the procedure in 58{\%} of cases; mean Rutherford class was 4.2 ± 1.2 for the entire cohort. Target CTOs included 14 anterior tibial, 9 posterior tibial, 5 peroneal, 1 tibio-peroneal trunk, and 8 popliteal artery lesions. Mean lesion length was 81 ± 64 mm; 15 lesions (41{\%}) were severely calcified. True lumen passage was obtained in 24 lesions (65{\%} technical success). Subintimal entry was achieved in 5 lesions (14{\%}). Procedural success was achieved in 26 lesions (70{\%}). Procedural failure was related to longer lesion length (P<.001), and mean length of failed lesions was 136 ± 65 mm. Conclusion. Viance and CrossBoss catheters were associated with an overall 70{\%} procedural success with predominantly true lumen crossing in a BTK-CTO cohort. CTO length remains an important determinant of device success.",
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T2 - A multicenter experience from the XLPAD registry

AU - Sethi, Salil

AU - Mohammad, Atif

AU - Ahmed, S. Hinan

AU - Germanwala, Samir

AU - Sarode, Karan

AU - Ortiz-Lopez, Carolina

AU - Banerjee, Subhash

AU - Prasad, Anand

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N2 - Background. Chronic total occlusions (CTOs) are reported in up to 40% of patients with symptomatic peripheral arterial disease. The Viance Crossing catheter (Covidien) and the CrossBoss catheter (Boston Scientific) are novel devices that facilitate either true lumen or subintimal navigation across CTOs. The purpose of this study was to examine the acute procedural success of these devices for popliteal and below-the-knee (BTK) CTOs. Methods. Clinical and procedural outcome data between Sept 2010 and October 2013 were analyzed from the ongoing multicenter XLPAD registry. Technical success was defined as true lumen passage of the catheter, while procedural success was defined as successful vessel revascularization inclusive of subintimal passage and reentry. Results. Twenty-nine patients underwent 31 procedures, in which 37 lesions were treated with the Viance and CrossBoss catheters. Mean age of the group was 69.1 ± 10.7 years and 26 patients were male (90%). All patients (100%) had hypertension, 62% were diabetic, and 48% were active smokers. Critical limb ischemia was the indication for the procedure in 58% of cases; mean Rutherford class was 4.2 ± 1.2 for the entire cohort. Target CTOs included 14 anterior tibial, 9 posterior tibial, 5 peroneal, 1 tibio-peroneal trunk, and 8 popliteal artery lesions. Mean lesion length was 81 ± 64 mm; 15 lesions (41%) were severely calcified. True lumen passage was obtained in 24 lesions (65% technical success). Subintimal entry was achieved in 5 lesions (14%). Procedural success was achieved in 26 lesions (70%). Procedural failure was related to longer lesion length (P<.001), and mean length of failed lesions was 136 ± 65 mm. Conclusion. Viance and CrossBoss catheters were associated with an overall 70% procedural success with predominantly true lumen crossing in a BTK-CTO cohort. CTO length remains an important determinant of device success.

AB - Background. Chronic total occlusions (CTOs) are reported in up to 40% of patients with symptomatic peripheral arterial disease. The Viance Crossing catheter (Covidien) and the CrossBoss catheter (Boston Scientific) are novel devices that facilitate either true lumen or subintimal navigation across CTOs. The purpose of this study was to examine the acute procedural success of these devices for popliteal and below-the-knee (BTK) CTOs. Methods. Clinical and procedural outcome data between Sept 2010 and October 2013 were analyzed from the ongoing multicenter XLPAD registry. Technical success was defined as true lumen passage of the catheter, while procedural success was defined as successful vessel revascularization inclusive of subintimal passage and reentry. Results. Twenty-nine patients underwent 31 procedures, in which 37 lesions were treated with the Viance and CrossBoss catheters. Mean age of the group was 69.1 ± 10.7 years and 26 patients were male (90%). All patients (100%) had hypertension, 62% were diabetic, and 48% were active smokers. Critical limb ischemia was the indication for the procedure in 58% of cases; mean Rutherford class was 4.2 ± 1.2 for the entire cohort. Target CTOs included 14 anterior tibial, 9 posterior tibial, 5 peroneal, 1 tibio-peroneal trunk, and 8 popliteal artery lesions. Mean lesion length was 81 ± 64 mm; 15 lesions (41%) were severely calcified. True lumen passage was obtained in 24 lesions (65% technical success). Subintimal entry was achieved in 5 lesions (14%). Procedural success was achieved in 26 lesions (70%). Procedural failure was related to longer lesion length (P<.001), and mean length of failed lesions was 136 ± 65 mm. Conclusion. Viance and CrossBoss catheters were associated with an overall 70% procedural success with predominantly true lumen crossing in a BTK-CTO cohort. CTO length remains an important determinant of device success.

KW - Chronic total occlusion

KW - Peripheral arterial disease

KW - Viance crossing catheter

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