Recanalization Devices for Totally Obstructed Vessels: Atherolytic Wire and Kensey Recanalization Catheter

At the present time approximately 400 000 patients undergo some form of reconstructive vascular procedure annually. Although it is true that 200 000 of these patients are undergoing an aortocoronary bypass procedure for coronary artery disease, the additional 200 000 are being treated for peripheral vascular occlusive disease. This includes 50 000 patients undergoing amputation annually. [Further analysis would indicate that 216 000 patients in 1988 will undergo percutaneous transluminal coronary artery angioplasty (PTCA). These figures are up sharply from the 3000 PTCAs performed in 1981 and considerably increased since 1983 when approximately 20 000 patients underwent PTCA. The 200 000 patients undergoing aortocoronary bypass procedures seem to have plateaued with the anticipated PTCA procedures approaching numbers as high as 400 000 procedures annually in 1992.] Patients undergoing peripheral angioplasty procedures number approximately 85 000 annually with an increase of 12% also occurring annually, and consequently a plateau of 100 000 patients/year should be achieved. This obviously is considerably less than the coronary nonsurgical interventional procedures and if the peripheral angioplasty population is to increase significantly, then obviously those patients with totally occluded vessels will necessarily be included in the series. For example, 100 000–150 000 patients are undergoing peripheral vascular reconstructive procedures while an additional 200 000 patients are being managed medically for either inoperable disease or surgically failed prior disease.