{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T09:05:22Z","timestamp":1790413522318,"version":"4.1.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,10,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The subintimal approach (SA) is widely used in endovascular therapy for femoropopliteal chronic total occlusion lesions. However, when compared with the intraluminal approach (IA), the safety and efficacy of SA in real\u2010world practice are not well characterized. Furthermore, there is a paucity of data on the clinical impact of subintimal and intraluminal wire passage (SWP and IWP, respectively) assessed by intravascular ultrasound.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              From the IVORY (Intravascular Ultrasound\u2010Supported Endovascular Therapy in Superficial Femoral Artery) registry, this study included 500 patients undergoing endovascular therapy for femoropopliteal chronic total occlusion lesions (SA, n=67; IA, n=433; and SWP, n=186; IWP, n=314). The primary end point was the cumulative 1\u2010year incidence of restenosis. The rate of perioperative complications was also assessed. Propensity score matching analysis was performed to adjust for the intergroup differences. After propensity score matching, the final study population consisted of 59 pairs (SA, n=59; IA, n=348) and 170 pairs (SWP, n=170; IWP, n=293), respectively. Cumulative 1\u2010year incidence of restenosis was comparable between the SA and IA groups (41.0% versus 43.4%,\n              <jats:italic>P<\/jats:italic>\n              =0.40). No significant difference in 1\u2010year restenosis rate between the SWP and IWP groups was observed (48.2% versus 40.8%,\n              <jats:italic>P<\/jats:italic>\n              =0.40), although the SWP group tended to be a higher rate of perioperative complications than the IWP group (8.2% versus 4.1%,\n              <jats:italic>P<\/jats:italic>\n              =0.07).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">At 1\u00a0year, both SA and IA showed acceptable results for femoropopliteal chronic total occlusion lesions. Cumulative 1\u2010year incidence of restenosis was not significantly different between SWP and IWP, whereas perioperative complications occurred more frequently in SWP than in IWP.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.umin.ac.jp\">https:\/\/www.umin.ac.jp<\/jats:ext-link>\n              ; Unique identifier: UMIN000020472.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.021903","type":"journal-article","created":{"date-parts":[[2021,10,6]],"date-time":"2021-10-06T11:04:06Z","timestamp":1633518246000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Subintimal Versus Intraluminal Approach for Femoropopliteal Chronic Total Occlusions Treated With Intravascular Ultrasound Guidance"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8939-0222","authenticated-orcid":false,"given":"Yusuke","family":"Tomoi","sequence":"first","affiliation":[{"name":"Department of Cardiology Kokura Memorial Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuyoshi","family":"Takahara","sequence":"additional","affiliation":[{"name":"Department of Diabetes Care Medicine Osaka University Graduate School of Medicine Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9927-9686","authenticated-orcid":false,"given":"Shoichi","family":"Kuramitsu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kokura Memorial Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1931-5769","authenticated-orcid":false,"given":"Yoshimitsu","family":"Soga","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kokura Memorial Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6829-7304","authenticated-orcid":false,"given":"Osamu","family":"Iida","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kansai Rosai Hospital Amagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7001-9220","authenticated-orcid":false,"given":"Masahiko","family":"Fujihara","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kishiwada Tokushukai Hospital Kishiwada Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daizo","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"Department of Cardiology Morinomiya Hospital Morinimiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0699-4248","authenticated-orcid":false,"given":"Kenji","family":"Ando","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kokura Memorial Hospital Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the IVORY Study 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