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Background <p>To describe the outcomes of endovascular treatment (EVT) using ultrasound (US) adjunct guidance for long-segment femoropopliteal chronic total occlusion (LSFP-CTO).</p> Methods <p>The medical record of 66 patients who underwent EVT, either conventional or US-guided, for LSFP-CTO recanalization at our institution between October 2016 and October 2023 was retrospectively reviewed. Baseline characteristics, procedural data, and clinical outcomes were analysed. Patency rates during post-procedural follow-up were evaluated using the Kaplan–Meier method.</p> Results <p>The mean total lesion length was 242.08 ± 37.57&#xa0;mm and 249.84 ± 46.52&#xa0;mm in the conventional EVT and US-guided EVT groups, respectively (<i>p</i> &gt; <i>0.05</i>). Technical success was achieved in 30 patients (93.75%) in the conventional EVT and 32 patients (94.12%) in the US-guided EVT group. Among patients with successful EVT, procedural time and contrast usage were lower in the US-guided EVT group than in the conventional group. No immediate complications of acute renal failure were observed in the US-guided EVT group. During post-procedural follow-up, no significant difference was observed in the incidence of access site complications between the two groups (6.3% vs. 2.9%, <i>p</i> &gt; <i>0.05</i>). A significant reduction in Rutherford category and an increase in ankle–brachial index were observed after US-guided EVT. Furthermore, the cumulative primary patency rate at 2&#xa0;years was 79.4% in the US-guided EVT group, with no statistically significant difference between the groups. The overall limb salvage rate was 88.2% at 2&#xa0;years in the US-guided EVT group.</p> Conclusions <p>US-guided EVT is a feasible, safe, and effective adjunctive method for the treatment of LSFP-CTO, associated with low complication rates. This approach reduces procedural time and contrast usage while providing a real-time adjunctive technique for establishing arterial cannulation during EVT.</p>

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Ultrasound-guided adjunct to endovascular treatment of long-segment femoropopliteal chronic total occlusion

  • 期刊论文

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  • 发表日期：

    2025年11月3日

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  • Da-shuai Wang,
  • Hui-jie Wang,
  • Yong-yu Zhang,
  • Hong-mei Wang,
  • Hui-yan Luo,
  • Xiu-fang Lv,
  • Hui Guo,
  • Hai-run Gan,
  • Peng-fei Pang

摘要

Background

To describe the outcomes of endovascular treatment (EVT) using ultrasound (US) adjunct guidance for long-segment femoropopliteal chronic total occlusion (LSFP-CTO).

Methods

The medical record of 66 patients who underwent EVT, either conventional or US-guided, for LSFP-CTO recanalization at our institution between October 2016 and October 2023 was retrospectively reviewed. Baseline characteristics, procedural data, and clinical outcomes were analysed. Patency rates during post-procedural follow-up were evaluated using the Kaplan–Meier method.

Results

The mean total lesion length was 242.08 ± 37.57 mm and 249.84 ± 46.52 mm in the conventional EVT and US-guided EVT groups, respectively (p > 0.05). Technical success was achieved in 30 patients (93.75%) in the conventional EVT and 32 patients (94.12%) in the US-guided EVT group. Among patients with successful EVT, procedural time and contrast usage were lower in the US-guided EVT group than in the conventional group. No immediate complications of acute renal failure were observed in the US-guided EVT group. During post-procedural follow-up, no significant difference was observed in the incidence of access site complications between the two groups (6.3% vs. 2.9%, p > 0.05). A significant reduction in Rutherford category and an increase in ankle–brachial index were observed after US-guided EVT. Furthermore, the cumulative primary patency rate at 2 years was 79.4% in the US-guided EVT group, with no statistically significant difference between the groups. The overall limb salvage rate was 88.2% at 2 years in the US-guided EVT group.

Conclusions

US-guided EVT is a feasible, safe, and effective adjunctive method for the treatment of LSFP-CTO, associated with low complication rates. This approach reduces procedural time and contrast usage while providing a real-time adjunctive technique for establishing arterial cannulation during EVT.