Ultrasound-guided antegrade femoral access: comparison between the common femoral artery and the superficial femoral artery

2010 ◽  
Vol 21 (6) ◽  
pp. 1323-1328 ◽  
Author(s):  
A. Gutzeit ◽  
N. Graf ◽  
E. Schoch ◽  
T. Sautter ◽  
R. Jenelten ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Common Femoral Artery ◽  
Ultrasound Guided ◽  
Femoral Access ◽  
The Common

Femoral Balloon-Oriented Puncture for True Lumen Reentry in the Common Femoral Artery After Subintimal Retrograde Recanalization of Superficial Femoral Artery Ostial Occlusion: The FORLEE Technique

2019 ◽  
Vol 26 (4) ◽  
pp. 490-495 ◽  
Author(s):  
Gabriele Testi ◽  
Tanja Ceccacci ◽  
Mauro Cevolani ◽  
Francesco Giacchi ◽  
Fabio Tarantino ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Balloon Catheter ◽  
Duplex Ultrasound ◽  
Cost Effective ◽  
Limb Ischemia ◽  
Common Femoral Artery ◽  
Anterior Tibial Artery ◽  
True Lumen ◽  
The Common

Purpose: To report a new technique to reenter the common femoral artery (CFA) true lumen after retrograde recanalization of a superficial femoral artery (SFA) with flush ostial occlusion. Technique: The technique is demonstrated in a 76-year-old woman with critical limb ischemia previously submitted to several surgical revascularizations. A duplex ultrasound showed flush ostial occlusion of the SFA and patency of the anterior tibial artery at the ankle as the sole outflow vessel. After unsuccessful antegrade attempts to recanalize the SFA, a retrograde guidewire was advanced subintimally up to the CFA, without gaining reentry. A balloon catheter was inflated in the subintimal plane across the SFA ostial occlusion. Antegrade access to the distal CFA was achieved with a 20-G needle, which was used to puncture the balloon. A guidewire was advanced into the balloon and pushed forward while the collapsed balloon was pulled back to the mid SFA. The antegrade guidewire was externalized through a retrograde catheter, which was pushed in the CFA true lumen. A retrograde guidewire was advanced and externalized through the femoral sheath, establishing a flossing wire. The procedure was completed in antegrade fashion. Conclusion: The FORLEE technique is a cost-effective option to gain the CFA true lumen after subintimal retrograde recanalization of an ostial SFA occlusion.

Use of a Steerable Sheath for Retrograde Access to Antegrade Branches in Branched Stent-Graft Repair of Complex Aortic Aneurysms

2018 ◽  
Vol 25 (5) ◽  
pp. 566-570 ◽  
Author(s):  
Vladimir Makaloski ◽  
Nikolaos Tsilimparis ◽  
Fiona Rohlffs ◽  
Konstantinos Spanos ◽  
E. Sebastian Debus ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Stent Graft ◽  
Femoral Artery ◽  
Common Femoral Artery ◽  
Aortic Aneurysms ◽  
Femoral Access ◽  
Aortic Stent Graft ◽  
Stent Graft Repair ◽  
The Common ◽  
Steerable Sheath

Purpose: To describe how to use a steerable sheath from a femoral access to catheterize antegrade branches in a branched aortic stent-graft. Technique: Following femoral cutdown, a stent-graft with antegrade branches destined for renovisceral target vessels was deployed in the desired position. A steerable sheath with a tip that rotates up to 180° was introduced from the common femoral artery and navigated to the antegrade branches for consecutive catheterization of the target vessels and deployment of one or more bridging stents per branch. The technique is demonstrated in 4 patients who underwent successful complex abdominal and thoracoabdominal branched endovascular repairs with 1, 2, and 4 antegrade branches. Conclusion: Retrograde access for complex aortic endografts with antegrade branches using a steerable sheath appears feasible and effective and may serve as an alternative to upper extremity access.

Femoral Vascular Access – Approaches and Available Devices

2012 ◽  
Vol 7 (2) ◽  
pp. 108
Author(s):  
Benjamin H Holland ◽  
Robert J Applegate ◽  
◽  
Keyword(s):  
Vascular Access ◽  
Femoral Artery ◽  
Healthcare Costs ◽  
Common Femoral Artery ◽  
Delivery Systems ◽  
Manual Compression ◽  
Femoral Access ◽  
Cardiac Procedures ◽  
The Common

Femoral access remains a vital route for many cardiac and non-cardiac procedures, including those involving the use of large delivery systems. In the common femoral artery access is extremely important to minimise complications and optimise use of closure devices. Dissatisfaction with haemostasis achieved by manual compression stimulated development of VCDs that provide quick and effective haemostasis after sheath removal. Despite shortening time to haemostasis and ambulation, a debate still rages regarding their overall contribution to reducing complications and healthcare costs.

Retrograde Femoral Access for Difficult Superficial Femoral Artery Occlusions

2018 ◽  
Author(s):  
Luke E. Sewall
Keyword(s):  
Femoral Artery ◽  
Iliac Artery ◽  
Superficial Femoral Artery ◽  
Ultrasound Guided ◽  
Femoral Access ◽  
Chronic Total Occlusions ◽  
Novel Approach ◽  
Ultrasound Guided Puncture ◽  
Guided Puncture ◽  
Safe Access

Obtaining retrograde femoral access is a novel approach to treat difficult chronic total occlusions of the femoral arteries. The technique involves direct ultrasound-guided puncture of the mid to proximal superficial femoral artery. Using this access, a guidewire is advanced in a retrograde manner into the patent femoral or iliac artery above. This wire is then snared and brought out the contralateral sheath to allow safe access into the occluded vessel. The recanalization procedure can then be completed in a standard fashion. This technique is extremely useful in flush occlusions of the superficial femoral artery origin or in occluded stents, both of which often have very difficult proximal caps. This chapter outlines the details of this unusual technique.

On-Site–Modified Sheath to Overcome the Undesirable Catheterization of the Profunda Femoris Artery During Antegrade Femoral Access

2020 ◽  
Vol 27 (3) ◽  
pp. 505-508 ◽  
Author(s):  
August Ysa ◽  
Marta Lobato ◽  
Amaia Arruabarrena ◽  
Ana M. Quintana ◽  
Roberto Gómez ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Common Femoral Artery ◽  
Simple Method ◽  
Femoral Access ◽  
Profunda Femoris Artery ◽  
Distal Marker ◽  
Antegrade Puncture ◽  
Repeated Passage ◽  
Profunda Femoris

Purpose: To present a simple method to avoid favored passage of a guidewire into the profunda femoris artery (PFA) after antegrade puncture of the common femoral artery. Technique: A 6-F conventional introducer sheath with a radiopaque distal marker is placed on the nurse’s table with its side port orientated to the 12 o’clock position. A small (2–2.5 mm) oval fenestration is created on the superior aspect of the sheath about 3 cm from its tip with a size 11 surgical blade. The modified introducer is passed over the angled 0.035-inch guidewire into the PFA and gently retrieved until the tip marker is ~3 cm from the femoral bifurcation. The dilator is removed, and the guidewire is withdrawn to the level of the fenestration, manipulated through it, and advanced further into the superficial femoral artery under fluoroscopic guidance. Conclusion: When repeated passage of the guidewire down the PFA persists despite conventional manipulation of the wire or needle, an on-site modification of the sheath is an easy alternative approach for the catheterization of the superficial femoral artery.

Tunneled Ipsilateral Sheath: A Novel Technique in Endovascular Management of Superficial Femoral Artery Ostial Lesions

2019 ◽  
Vol 53 (4) ◽  
pp. 337-340
Author(s):  
Mohamed I. EL-Maadawy ◽  
Ahmed M. Balboula ◽  
Hossam Zaghloul
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Common Femoral Artery ◽  
Endovascular Management ◽  
Novel Technique ◽  
Antegrade Approach ◽  
Technical Details ◽  
Subcutaneous Tunnel ◽  
The Common ◽  
Ostial Lesion

Ostial lesions of the superficial femoral artery preclude the use of ipsilateral common femoral artery antegrade approach. Access via either the contralateral common femoral or the brachial arteries are the 2 alternative classical approaches. Conversely, using an ipsilateral antegrade approach, through a partially inserted sheath, usually leaves the sheath insecure and frequently hits ostial lesion itself during insertion. Dislodgment from the artery frequently occurs, resulting in loss of access. We describe a technique whereby we insert 2 to 3 cm of the sheath into the common femoral artery and the remaining part of the sheath resides in a fashioned subcutaneous tunnel of the lowermost abdomen. Technical details are provided as well as the results of using this technique on 37 patients. The technique is safe, easy to perform, and reproducible.

scholarly journals Experience of endovascular treatment of common femoral artery pseudoaneurysm with usage Angio-Seal Closure Device

2020 ◽  
Vol 29 (3) ◽  
pp. 71-79
Author(s):  
Yu.V. Cherednichenko
Keyword(s):  
Endovascular Treatment ◽  
Femoral Artery ◽  
Common Femoral Artery ◽  
Left Vertebral Artery ◽  
Closure Device ◽  
Severe Stenosis ◽  
Femoral Access ◽  
Artery Pseudoaneurysm ◽  
The Common ◽  
The Right

One case of successful treatment of the common femoral artery pseudoaneurysm with usage of modified technique of pseudoaneurysm neck sealing with Angio-Seal with retrograde access percutaneously is presented.A 52-year-old man was admitted in the recovery period of ischemic stroke in the left carotid basin. A total subtraction cerebral angiography was performed, which revealed severe stenosis in the bulb of the left internal carotid artery with ulcerated contour and severe stenosis in the ostium of the left vertebral artery. Hemostasis was performed by compression. A pressure dressing was applied for a day. The puncture site was without any problems on the next day. The patient received double antiplatelet therapy 5 days before endovascular surgery. Before surgery, palpation in the right inguinal region determines a rounded painful compaction. Carotid stenting on the left side, stenting of the left vertebral artery and control angiography of arteries of the right lower limb were performed by left-side femoral access. Pseudoaneurysm in the bifurcation of the right common femoral artery with a narrow neck was verified. Attempts to cure it by manual compression under angiographic control and ultrasound control were unsuccessful.After 6 days, endovascular treatment of pseudoaneurysms of the right common femoral artery with closure of the pseudoaneurysm neck was performed. The right common femoral artery was catheterized with left radial access with diagnostic catheter on a hydrophilic wire 0.035ʺ. This wire was carefully advanced into pseudoaneurysm through a defect in the common femoral artery and subsequently served as a marker. The pseudoaneurysm was punctured with miniaccess needle, then the 0.018ʺ wire passed through the pseudoaneurysm neck into the femoral artery retrogradly, focusing on the “marker” wire. A 6F radial introducer is introduced along 0.018ʺ wire. Further, this access was used to close the pseudoaneurysm neck with the Angio-Seal Closure Device 6F according to the standard method. In a control angiograms, a pseudoaneurysm did not contrast, arteries are passable without stenosis and signs of dissection. Hemostasis at the site of puncture of the radial artery was performed with a hemostatic bracelet. The patient was discharged from the clinic to continue treatment in a rehabilitation neurological center.This technique of endovascular treatment of postcatheterization pseudoaneurysms of the common femoral artery is quite simple, causing minimal discomfort for the patient. The closure is immediate and angiographically controled. The use of radial access instead of contralateral femoral access for introducing of a “marker” wire and angiographic control reduces the risk of local complications at the access site.

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