Predictors of Successful Revascularization of Chronic Total Occlusions in Superficial Femoral Arterial Lesions with Re-Entry Devices

Abstract

Objective: To evaluate the relevance of traditional predictors of technical success of percutaneous revascularization of chronic total occlusions (CTOs) in the superficial femoral artery (SFA) with the aid of reentry devices in which other conventional measures have failed, and whether new predictors of success would be uncovered. Background: The Trans-Atlantic Inter-Society Consensus (TASC) score has provided guidelines for the optimal revascularization strategy. With current technological advancements and operator expertise, a reevaluation of these traditional predictors of success is warranted. Methods: We conducted a retrospective analysis of 36 occluded SFAs undergoing peripheral vascular interventions (PVI) from January 2005 to June 2013. Patient charts and angiograms were reviewed. Univariate analyses were performed with the t‐test and Chi Squared test. Results: All traditional parameters failed to predict procedural success or failure. Year-to‐year results were analyzed; during Period 1, there was a 5.6% success rate. During Period 2, there was a 66.7% success rate. Conclusion: Traditional predictors of technical success in chronically occluded SFA lesions do not hold up in the current era, especially with the use of distal reentry devices. This is most likely due to technological advances (e.g. distal reentry devices), as well as increasing operator expertise.