Abstract
BackgroundRecanalization of graft limb occlusion can prove challenging and the use of the GoBack crossing and reentry device may be a suitable option, especially when there is no other way to restore flow with an usual endovascular approach. The GoBack catheter is a novel device designed to enhance pushability, and to enable direction-change inside hard plaques and crossing of tough lesions, even when they involve graft fabric.Case presentationIt’s reported a case of a 76-year-old male who presented with claudication, previous placement of an aorto-bi iliac graft by open surgery for a ruptured abdominal aneurysm 10 years ago that, over time, developed severe kinking on the left limb and a fabric occlusion on the right limb. After several unsuccessful attempts to cross the occlusion of the right common iliac artery, the GoBack™ was deployed to create a lumen through graft’s folds. After angioplasty and stenting a satisfactory result was achieved, restoring flowCT-scan at 1 month and duplex ultrasound (DUS) at 3 months confirmed the patency of ilio-femoral axis.ConclusionsThe advent of this new CTO crossing device has the potential to facilitate recanalization of some of the most challenging occlusions. Facilitating more consistent distal entry and allowing for a decrease in crossing time. Therefore, the GoBack catheter should be considered as a potential complementary tool to treat vascular occlusions via endovascular approaches, especially when classical endovascular techniques fail.
Highlights
ConclusionsThe advent of this new CTO crossing device has the potential to facilitate recanalization of some of the most challenging occlusions
Recanalization of graft limb occlusion can prove challenging and the use of the GoBack crossing and reentry device may be a suitable option, especially when there is no other way to restore flow with an usual endovascular approach
The GoBack catheter should be considered as a potential complementary tool to treat vascular occlusions via endovascular approaches, especially when classical endovascular techniques fail
Summary
Classic endovascular approaches often fail to cross occlusions, as in this particular case. In the presented case, following failed crossing attempts, the occlusion could have been addressed with stenting of the left iliac axis and a femorofemoral cross-over surgical bypass from the left to right side or conservative management. With the assistance of the GoBack catheter, flow was regenerated and stenting was successfully performed in a less invasive, precise and time-efficient manner. The GoBack catheter is an effective vessel lumen crossing and re-entry device, suitable for tough occlusions and interventional radiologists as well as clinicians should consider this catheter as a potential complementary interventional instrumentation tool
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