Radiofrequency Wire for the Recanalization of Chronic Arterial Occlusions That Have Failed Conventional Endovascular Techniques

Purpose Describe the technique and present the results of RF wire puncture for the recanalization of chronic arterial occlusions in symptomatic patients. Materials and Methods Between January and June 2012, 6 patients (5 male), age ranging from 58-72 years, presented with signs and symptoms of arterial occlusive disease. The lesions ranged from TASC C to D and were identified within the common iliac and superficial femoral artery. Despite multiple repeat attempts at recanalization using conventional endovascular techniques, the lesions were unable to be crossed. PowerWire RF wire (Baylis Medical, Canada) was advanced (via intra-luminal or subintimal approach) within a 5-Fr KMP catheter using a 10 mm snare (iliac lesions) or arterial wall calcification (femoral lesions) as a target. Pre-stent balloon angioplasty was followed by stent placement. If the RF wire puncture was inadequate, a new location was pursued. Clinical assessment along with targeted diagnostic and imaging follow up was performed at 30 days and then at 3, 6, and 12 months. Results All patients were successfully treated with RF wire after previous failed attempts at recanalization using different combinations of catheter/wire techniques. There were no complications. All patients improved clinically and imaging of the treated segment showed patency at 10 months mean follow-up. Conclusion RF wire is a safe alternative in the recanalization of chronic arterial occlusions when conventional techniques have failed and provides an endovascular solution for patients who would otherwise be forced into undergoing surgical repair.