Endovascular > Peripheral Disease >
BTK > Cases

Successful laser ablation and Kissing Balloon Dilation for below-knee bifurcation CTO
- Operator: Kenji Suzuki, MD
Clinical Information

- Relevant clinical history and physical examination:
The patient was 57 years old woman. Her coronary risk factors were diabetes, hypertension, and hyperlipidemia. She has felt severe intermittent claudication. One year ago, Luminexx6/30mm was deployed for her right superficial femoral artery (SFA). However, she recently had a recurrence of claudication and felt leg discomfort even in rest. Her dorsal and postero-tibial artery pulse was not detected.

- Relevant test results prior to catheterization:
ABI measurement showed 0.63 on right leg and normal range o left leg. CT angio pointed out restenosis of Luminexx and worsening of below knee

- Relevant catheterization findings:
Severe restenosis of right SFA Luminexx (Figure 1) and total occlusion of popliteal artery distal was found. (Figure 2).

Interventional Management
- Procedural step:
We performed percutaneous peripheral intervention via right femoral artery. Using antegrade puncture, long sheath was inserted. At first, we used 6/40mm POBA for Luinexx in-stent restensis (Figure 3, Figure 4, Figure 5). And next, Ruby intermediate with Ichibanyari PAD could cross the lesion to postero-tibial artery (PTA) (Figure 6). We used Laser 1.4mm ablation to PTA (Figure 7, Figure 8), then Genity 2.0/100 POBA (Figure 9, Figure 10, Figure 11). De ja-vu could pass the lesion to peroneal artery (PA), and Genity 2.5/100 was dilated (Figure 12, Figure 13). We could gain good flow to PA, but no reflow to PTA occurred (Figure 14). Finally, we did kissing balloon dilation using Ikazuchi PAD 2.5/40 to PTA and Genity 2.5/100 to PA (Figure 15). We obtained good flow to both arteries (Figure 16, Figure 17).
Sign in to leave a comment.
CardioVascular Research Foundation (CVRF)
2nd Floor, Asan Institute for Education & Research, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
Tel_82.2.3010.4792 | Fax_82.2.475.6898
ǥ̻ ڽ | ı øȷ43 88, ƻ꺴 ƻ걳 2 | ڵϹȣ 215-82-06387
å_ | ȭȣ_02.3010.4792 | ѽȣ_02.475.6898
Copyright © CVRF, Seoul, Korea. All rights reserved.