Lorenzo Patrone (London, UK) shares with BLearning at CIRSE 2019 (7–11 September, Barcelona, Spain) the benefits of using the OUTBACK™ Elite Re-entry Catheter (Cordis, a Cardinal Health Company) in chronic total occlusions—in any arterial segment from the iliacs to the toes.
Patrone speaks about the use of the re-entry device used via the standard antegrade access or via a distal superficial femoral artery/below-the-knee retrograde approach to be able to re-enter in the proximal superficial or common femoral artery in patients with history of previous bypass, where the need and the difficulty in achieving an accurate re-entry are maximum.
He emphasises the importance of operator expertise and recommends for the device to be used earlier, rather than later in the treatment plan [to avoid dissection of the subintimal space], in order to achieve effective outcomes. Regarding costs, his opinion is that the cost of the device itself is nothing in compared to [savings] in “time, contrast, and radiation to the patient”.
“In my experience, to cross the lesion is the most challenging part [of the procedure],” says Patrone, “once you cross the lesion, you can angioplasty, you can stent, and the patient will have a new vessel, new vessel means new blood to the limb, and new blood to the limb means new life to the patient”.