RR6. The Use of Reentry Devices Improves the Technical Success, Safety, and Patency of Recanalization of Chronic Total Occlusions of the Iliac Arteries

Our aim was to analyze the effect of reentry device use on iliac artery chronic total occlusion (CTO) recanalization outcomes. A retrospective review of patients with iliac artery CTO treated with subintimal angioplasty (SIA) from 2006 to 2011 was completed. We then compared the outcomes of two groups: those procedures completed with versus those procedures completed without a reentry device using SPSS software (IBM, Armonk, New York). Of the 121 iliac artery CTOs that underwent SIA, 32 cases used a reentry device while 89 did not. For the entire cohort, the mean age was 65, male 45%, hypertension 76%, hyperlipidemia 71%, diabetes 36%, and CAD 56%. Indications for the procedure included claudication (60%) and critical limb ischemia (40%). The clinical profile and indications for intervention were not statistically different for the 2 groups. Combining TASC C&D lesions, the reentry device group had a trend toward a higher percentage of more advanced lesions compared to the non reentry device group (82% versus 66% P = .07). Yet despite the more advanced lesions, the technical success rate was higher in the reentry device group (100% versus 77% P = .002). Combined major complication rate, retrograde aortic dissection, and 30-day mortality rate of the reentry group was also reduced (0% versus 10% P = .04). Lastly, the 1, 2 and 3 years primary and secondary patency rates, especially with long term follow up, appear to be improved with the use of reentry devices; primary patency at 1, 2, and 3 years for the reentry device group versus the non reentry device group (100%, 100%, 100% versus 84%, 72%, 64% P = .02), and secondary patency at 1, 2, and 3 years for the reentry device group versus the non reentry device group (100%, 100%, 100% versus 93%, 91%, 77% P = .125). The routine use of reentry devices further improves the technical success, safety, and primary patency of SIA recanalization of iliac artery CTO.