Abstract
Endovascular therapy for chronic complete occluded lesions in the lower limbs requires some additional ingenuity in terms of the therapeutic procedure. The choice of guidewire and the shape of the guidewire tip are technically important elements. In addition, it is crucial to know where the guidewire moves through the true lumen. Intravascular ultrasound (IVUS) and body surface sonography are suitable methods for this purpose. Information on the entrance and exit points when the guidewire passes through the occlusion site is particularly important. It is no exaggeration to say that the procedure using ultrasonic examination is not only for ensuring the safety of endovascular treatment but is also the key to successful treatment.
Body surface duplex-guided EVT may be useful for cases with in-stent restenosis or occluded lesions, or in patients with contrast medium allergy or with chronic kidney disease. We present an actual case we encountered and discuss the usefulness and limitations of these methods.
