Correction

Correction: The following abstract is from page 13 of the Cath Lab Digest February 2003 Supplement A, Opening New Channels: The Revascularization of Vessels with Chronic Total Occlusions. The conclusion was inadvertently omitted from the abstract. Cath Lab Digest regrets the error. Experience with the LuMend Frontrunner CTO Catheter System for the Treatment of TASC D SFA Lesions L.E. Shindelman, MD* *From Robert Wood Johnson University Hospital, New Brunswick, New Jersey; St. Peter's University Hospital, New Brunswick, New Jersey Background: Treatment of TASC D SFA occlusions poses several technical challenges. Guide wires often lack the control and strength to cross long occlusions or, once sub-intimal, present the challenge of re-entry into the vessel lumen. Other important considerations are protection of the deep femoral artery and accurate stent deployment at the origin of the SFA. This is a report of my technique and initial experience utilizing the LuMend Frontrunner CTO Catheter System in treating TASC D SFA lesions. Methods: Originating from the contra-lateral femoral artery, an arterial sheath is negotiated over the horn and positioned at the common femoral artery of the affected limb. Through this arterial sheath, arteriograms are performed and a guide wire is placed across the deep femoral artery to protect this important collateral during the procedure. With the patient transferred from a supine to prone position, through a percutaneous approach, under road-mapping conditions, the popliteal artery is accessed and secured with a 6 French (Fr) arterial sheath. With the LuMend Frontrunner CTO Catheter System, introduced in a retrograde manner from the popliteal artery, controlled blunt microdissections are made to facilitate guide wire placement across the occluded segment of SFA. Wire placement is followed by a limited angioplasty, followed by nitinol stent deployment of the entire affected segment of artery, followed by post-stent deployment dilatation to native vessel diameter. A total of 7 TASC D SFA lesions were treated in 7 patients (5 male and 2 female) with a mean age of 65 years. All patients had severe claudication with debilitating symptoms. Four patients had diabetes mellitus, and 3 patients had end-stage renal disease. Four patients were treated for limb salvage and three for severe claudication. The average occlusion length was 26 cm. Results: Six of the 7 lesions were crossed successfully with the Frontrunner (86%) with no procedural complications. Angioplasty and nitinol stent deployment were performed in all patients. Mean stent length was 280 mm, with stent diameters from 6-8 mm. The mean increase in ankle/brachial index was 0.30 (0.17 to 0.5). Over a follow-up period of 3 to 8 months, all patients were asymptomatic. Conclusion: The use of the Frontrunner CTO Catheter System appears to be safe and effective in its use to facilitate guide wire placement across TASC D SFA occlusions.

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