[MO-83] Presentation Awards
CT&MRI fusion EVT for Leriche syndrome
【Objectives】
A man aged 94 visited our hospital due to intermittent claudication of left lower limb.
He is young for his age and often goes golfing.
He had right axial-bi.femoral bypass surgery about 5 years ago.
CT revealed graft to left femoral was occlueded and native aorta was occluded at the distal part of renal artery.
Aortic angiography by catheter inserted from left upper limb showed total occlusion of aorta distal to renal artery. And the proximal external iliac artery was contrasted through the collateral artery.
【Methods】
CT angio can identify running direction of the blood vessel and MRI can reveal plarque characteristics in the chronic total occlusion lesion. We can visualize the route to cross a wire and realize which wire to use by using the fusion of the two image and angiography.
First, we advanced a wire from left femoral. A relatively soft wire passed through CTO lesion which is high intensity area of MRI image. However, we couldn’t cross a wire ahead of there. Therefore, we used harder wire and bi-directional approach to add another approach form left upper limb. Finally, we succeeded to cross the wire entirely through the true lumen without any trouble.
【Results】and【Conclusions】
We operated a safer and more reliable EVT for Leriche syndrome by using CT&MRI fusion. CT&MRI fusion EVT is very useful particularly to chronic total occlusion lesion in aortic or iliac area.
A man aged 94 visited our hospital due to intermittent claudication of left lower limb.
He is young for his age and often goes golfing.
He had right axial-bi.femoral bypass surgery about 5 years ago.
CT revealed graft to left femoral was occlueded and native aorta was occluded at the distal part of renal artery.
Aortic angiography by catheter inserted from left upper limb showed total occlusion of aorta distal to renal artery. And the proximal external iliac artery was contrasted through the collateral artery.
【Methods】
CT angio can identify running direction of the blood vessel and MRI can reveal plarque characteristics in the chronic total occlusion lesion. We can visualize the route to cross a wire and realize which wire to use by using the fusion of the two image and angiography.
First, we advanced a wire from left femoral. A relatively soft wire passed through CTO lesion which is high intensity area of MRI image. However, we couldn’t cross a wire ahead of there. Therefore, we used harder wire and bi-directional approach to add another approach form left upper limb. Finally, we succeeded to cross the wire entirely through the true lumen without any trouble.
【Results】and【Conclusions】
We operated a safer and more reliable EVT for Leriche syndrome by using CT&MRI fusion. CT&MRI fusion EVT is very useful particularly to chronic total occlusion lesion in aortic or iliac area.