Novel Transseptal Approach Tackles Chronic Peripheral Arterial Occlusions

Background: Chronic peripheral arterial occlusions are often challenging lesions to treat. Subintimal angioplasty is a technique used to recanalize lesions that fail standard angiographic approaches. However, conventional subintimal angioplasty carries with it a 20% failure rate. Objective: To investigate a novel technique utilizing a transseptal needle to re-enter the true lumen when the traditional subintimal technique fails. Methods: This study was an Institutional Review Board-approved retrospective review of cases at the authors' institution. In total, 98 cases of chronic arterial occlusions were treated endovascularly within a 2-year period. In 23 of these cases, traditional methods of re-entering the true lumen failed and the transseptal needle technique was utilized. Chart review included clinical data, procedural time, and complications. Results: The modified transseptal needle (MTSN) technique was performed in 23 patients. A 71-cm 18-gauge transseptal needle with a 21-gauge more...