Comments about the Cordis OUTBACK LTD Re-Entry Catheter | Which Medical Device

I have always been a little sceptical of this device, feeling that it was a rare thing not be able to get back into the true lumen when doing a subintimal angioplasty. I finally used it for the first time this week and was impressed.

The patient (see images) was a 100yard claudicant with an approx 10cm mid sfa occlusion. We thought it would be a simple subintimal but we failed to re enter the true lumen despite several attempts.

We inserted the device over an 0.014 inch stabiliser wire which was in the subintimal tract. Following the video we orientated the catheter so the L pointed to the true lumen which became a T shape screening at 90 deg superimposed over the middle of the vessel true lumen. We withdrew the wire and advanced the ‘needle’ then probed with the wire. Its was obvious we had gone too far with the needle (which is quite hard to see)and it was probably in the opposite vessel wall. We withdrew it slowly and re probed several times which then saw the wire pass freely down the true lumen. The device was removed, catheter inserted, wire changed and angioplasty successfully performed. The result as you can see is not pretty but flow was excellent so we did not re plasty.

I would have given it 5 stars if it was cheaper, nevertheless if the alternative is surgery then it gives good value