P5202The effectiveness of ultrasound-guided tibial artery endovascular interventions for chronic total occlusion lesions in critical limb ischemia

Background: Tibial artery endovascular interventions (TAEIs) are widely accepted as an alternative to surgery for the treatment of critical limb ischemia (CLI). However, the technical success rate of TAEIs is not sufficient because of the lesion severity.Recently, ultrasound-guided (US) EIs for femoropopliteal (FP) lesions are notable as a noninvasive and useful modality to increase technical success rate. Therefore, we investigated whether ultrasound-guided TAEIs are usefull as well as for FP lesions. Method: This is non-randomized, retrospective, single center study. From April 2007 to Janualy 2016, a total of 169 tibial CTO lesions (135 limbs, 125 patients) in CLI patient with tissue loss were treated in our institute. We started to treat US-guided TAEIs for CLI from March 2014. These lesions were classified into two groups, US-guided group (30 lesions, 26 patients) and non US-guided group (139 lesions, 99 patients). Study end point was technical success for tibial CTO lesions. Results: There was no significant difference in patient characteristics between two groups. Although, the calcified lesion rate was more higher in patients with US-guided group (US-guided group: 92.7% vs non-US-guided group: 66.7%, P=0.01), technical success rate was significantly higher in US-guided group (US-guided group: 70.0% vs non US-guided group: 51.0%, P=0.04).