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Heavily calcified chronic total occlusion of common iliac artery successfully treated with Tornus microcatheter and rotational atherectomy  Masahiko Hara,

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Presentation on theme: "Heavily calcified chronic total occlusion of common iliac artery successfully treated with Tornus microcatheter and rotational atherectomy  Masahiko Hara,"— Presentation transcript:

1 Heavily calcified chronic total occlusion of common iliac artery successfully treated with Tornus microcatheter and rotational atherectomy  Masahiko Hara, MD, Masami Nishino, MD, PhD, Ken Matsuoka, MD, Yoshio Yamada, MD, PhD  Journal of Vascular Surgery  Volume 48, Issue 3, Pages (September 2008) DOI: /j.jvs Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

2 Fig 1 Top, Schematic illustration and (Bottom) photograph show the 2.1F Tornus (Asahi Intecc, Aichi, Japan) microcatheter. It is made of eight pieces of stainless steel wire rope into a spiral structure that provides high penetration power through its screwing effect. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

3 Fig 2 a, Arteriogram demonstrates a heavily calcified chronic total occlusion of the right common iliac artery. b, First, we managed to cross a guidewire using a 6F long sheath, 4.2F internal mammary artery catheter, and 2.4F microcatheter. c, Because the microcatheter and 1.5- × 6-mm balloon catheter could not cross the lesion, we advanced the Tornus penetration microcatheter (Asahi Intecc, Aichi, Japan) into the vessel. d, We exchanged the guidewire with a RotaWire floppy (Boston Scientific, Natick, Mass), and rotational atherectomy was performed, which led to stent implantation. e, Final arteriography after stent implantation revealed satisfactory morphologic results. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

4 Fig 3 Before stenting, the (a) short-axis and (b) long-axis views with intravascular ultrasound (IVUS) showed heavily calcified stenotic lesions. Quantitative assessments using IVUS revealed that the minimum lumen diameter was 2 mm, reference diameter of the proximal portion of the lesion was 10 mm, distal reference was 9 mm, and the exact lesion length was 45 mm. After stenting with a postdilatation technique, the (c) short-axis and (d) long-axis views of IVUS demonstrated round symmetrical expansion of the stent and a sufficient aortic lumen, with a minimum stent diameter of 7 mm. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

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