Cadaveric study demonstrates successful simulation and endovascular laserwire crossing of arterial total occlusions, indicating utility for vascular device testing.
Peripheral artery disease (PAD) chronic total occlusions (CTOs) are challenging to simulate. The aim of this study was to evaluate a simulated human cadaveric CTO model. Simulated CTOs using either bone fragments for hard lesions or muscle/fascia for soft lesions were created in human arteries followed by endovascular crossing attempts. The primary outcome was immediate technical failure (ITF). Optical coherence tomography (OCT) and histological evaluation was also completed, and a novel laserwire prototype (Light Matter Interaction Inc.) was used in two cases. Seven hard and 1 soft CTO were created. ITF occurred in 43% of hard CTOs while the soft CTO had no technical difficulty. OCT and histopathological evaluation provided evaluation of vessel wall injury. Laserwire testing was carried out on two lesions, resulting in successful crossing showing the advantages of using this model for endovascular device testing and development.
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Crichton et al. (2026) studied this question.
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