Critical Limb Ischemia Lab Report

Critical limb ischemia (CLI) is associated with high rates of limb loss due to amputation; usually within six month of the presentation of symptoms. CLI presents as the result of a chronic total occlusion (CTO) which can lead to lower revascularization rates. A clear majority of patient with CLI present with symptoms of ischemic rest pain, lifestyle-limiting claudication or CLI with tissue loss. PCI in the Cath Lab is a favored minimally invasive approach to address CTOs. However, this procedure has high failure rates due to the failure to cross the distal vessel from the occlusion. Crossing rates have improved with the advancement of reentry catheters, and other devices. One device used for recanalization of the true lumen of CTOs is made
The catheter is attached to the transducer hand-piece. “When activated, vibrational energy is transmitted to the tip of the catheter creating a mechanical impact and cavitation that aids in breaking down occlusive material in the artery and in tunneling through the CTO”. “Following access the recanalization catheter is delivered through a standard guide catheter over a guidewire to the occlusion site”. Once its positioned, the operator retracts the guidewire into the catheter lumen at least 1mm from the catheter tip and activate the system by stepping on the foot switch. “Each recanalization catheter can be activated for a total of five minutes, at which point it could be replaced with another catheter if progress is being made”. The recommended number of catheters is no more than three, equivalent to fifteen minutes of generator activation time which is measured by a counter on the control panel. “As the recanalization catheter progresses through the lesion, the operator can stop the generator at any time and advance the guidewire distally to the occlusion”. Once a wire reaches the central lumen distal to the lesion, the catheter is removed. The physician than proceeds with stenting or DCB treatments to end the case. The studies conducted demonstrate that the device achieved IVUS confirmed intraluminal crossings and