Distal Re-Entry to Treat Lower Limb Chronic Total Occlusions Using a Novel Electrically Guided Re-Entry Catheter

Introduction: Endovascular treatment of challenging infra-inguinal peripheral vascular disease is increasingly common because of new techniques and improved tools. The use of a novel electrically guided 5 F re-entry catheter is presented. By emitting a minute electrical field, detected by a target wire inserted from an opposing access, the catheter's orientation is accurately displayed to the operator, allowing precise re-entry without the need for fluoroscopic alignment. Results: An 84 year old man with tissue loss was treated for a long occlusion of the superficial femoral artery and tibial vessels. Successful subintimal recanalisation was achieved with the help of the ePATH re-entry catheter, restoring inline flow to the foot. Conclusions: This re-entry catheter benefits from an intuitive alignment method, smaller profile, and operator adjustable needle travel, making it a versatile tool for endovascular cases. (C) 2021 The Authors. Published by Elsevier Ltd on behalf of European Society for Vascular Surgery.