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Intravascular ultrasound findings after knuckle wire technique for superficial femoral artery occlusion

T Takama, K Hirano, M Nakano, O Iida, K Suzuki, Y Miyashita, H Ishimori, Y Ito, R Tsukahara & T Muramatsu

Aim: We assessed the wire behavior by using intravascular ultrasound when knuckle wire technique is performed for chronic total occlusion of the superficial femoral artery. We investigate the relationship between the angiogram and the wire behavior. Methods: This retrospective multicenter study enrolled 48 patients (50 limbs) in whom intravascular ultrasound could be performed successfully after knuckle wire technique. Results: The wire passed intraluminally from the proximal cap to the reentry site in nine cases (18%). Once the wire entered the subintimal space, it remained in the subintimal space through the occlusion (32/34 cases; 95%). Conclusion: The wire was more likely to advance intraluminally if the chronic total occlusion had a tapered proximal cap and an abrupt distal margin.