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The Aortic Bifurcation Angle as a Factor in Application of the Outback for Femoropopliteal Lesions in Ipsilateral Versus Contralateral Approaches
Purpose To assess the technical success of the Outback
reentry device in contralateral versus ipsilateral approaches
for femoropopliteal arterial occlusion.
Materials and Methods A retrospective review of patients
treated for critical limb ischemia (CLI) using the Outback
between January 2013 and July 2016 was performed. Age,
gender, length and site of the occlusion, approach site,
aortic bifurcation angle, and reentry site were recorded.
Calcification score was assigned at both aortic bifurcation
and reentry site. Technical success was assessed.
Results During the study period, a total of 1300 endovas-
cular procedures were performed on 489 patients for CLI.
The Outback was applied on 50 femoropopliteal chronic
total occlusions. Thirty-nine contralateral and 11 ipsilateral
antegrade femoral were accessed. The device was used
successfully in 41 patients (82%). There were nine failures,
all in the contralateral approach group. Six due to inability
to deliver the device due to acute aortic bifurcation angle
and three due to failure to achieve luminal reentry. Pro-
cedural success was significantly affected by the aortic
bifurcation angle (p = 0.013).
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