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Case Sharing: Experience at Tokeidai Memorial Hospital and The Kurashiki Central Hospital Style
Dr. Yuki Shima, Kurashiki Central Hospital
Kurashiki Central Hospital has a policy of performing EVT with an emphasis on intraluminal wiring, as data have been reported showing that central wiring can suppress severe dissection1), therefore, we aim to minimize dissection. DCB is deployed by performing intraluminal wiring using echoguide or other techniques.
Advantages of EVUS Guidance
- Reduction of radiation exposure time/use of contrast media
- More accurate visibility of guidewire travel
- Heavy wires with excessive tip weight can be used from the beginning
- Reduces number of wires used
- Completion of the procedure using only a progressive approach
- Complete the procedure with an intraluminal approach
Case 1
Woman in her 70s
- Diagnosis: PAD Rutherford 3
- Target: Lt. SFA-POP CTO
- ABI: Rt. 0.78 Lt. 0.29
- Cre 0.70, eGFR 62.8
Preoperative: Lower extremity arteriography
The procedure was started in ipsilateral sequential fashion, with occlusion from the entrance of the SFA to P1, with a short pause there, and further occlusion was observed from P2. Slight blood flow was observed in the anterior tibial artery.
The procedure was started with EVUS guidance from the beginning, and the tapered wire was advanced....
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