A Simplified Pull-Through Angioplasty Technique without a Snare Device

The pull-through angioplasty technique allows stable wire tension and stabilization of the device during the procedure. In this technique, a guide wire is passed from one sheath to another, usually with the aid of a snare device. We describe the treatment of occlusive subclavian artery disease and lesion at the origin of the vertebral artery employing a brachiofemoral pull-through technique without using a snare device. In this technique, the guide wire is advanced from the femoral artery to the brachial artery. The guide wire is directly inserted into the sheath placed at the brachial artery. The brachial artery is compressed proximal to the point of sheath insertion to prevent bleeding. The sheath is extracted temporally and the guide wire is caught outside of the body. The sheath is then introduced again through the guide wire. We used the pull-through technique without a snare device in seven cases, and we were able to build the pull-through system in six of these cases without a snare device. This pull-through technique without a snare device is not difficult to use, and may reduce the time and cost of angioplasty procedures.

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Prevalence of Subclavian Artery Stenosis in Patients With Coronary Artery Disease

10.21203/rs.3.rs-56393/v1 ◽

2020 ◽

Author(s):

Assem AbdelAziz Hashad ◽

Abdalla Elagha

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Vertebral Artery ◽

Doppler Ultrasound ◽

Subclavian Artery ◽

Screening Method ◽

Arterial Disease ◽

Artery Stenosis ◽

Subclavian Artery Stenosis ◽

Artery Disease

Abstract Background : Atherosclerosis is the most common and serious vascular disease that affects both the brain and the heart .(1) Subclavian stenosis/occlusion is a marker for atherosclerotic disease (eg, carotid, coronary & lower extremity arteries) and future adverse cardiovascular events. (2) In this study, we identified the prevalence of subclavian artery stenosis in patients presented with coronary artery disease (CAD) through changes in the Doppler tracing of vertebral arteries that appear to represent a clue of subclavian artery stenosis.Methods: On the basis of extracranial Doppler ultrasound & supplementary intracranial Doppler ultrasound, we assessed the pattern of Doppler waveform in both carotid & vertebrobasilar systems among 100 consecutive patients who were hospitalized for CAD in the cardiovascular department.Results: Among 100 consecutive CAD patients studied, we identified stenosis and occlusion of subclavian artery in 5 patients (5%). In those patients, subclavian arterial disease was indirectly discovered by changes in Doppler waveforms of vertebral artery. Conclusions: Prevalence of subclavian artery stenosis in patients with CAD is 5%. Changes in the pulse contour of antegrade vertebral artery Doppler waveforms seem to represent a good screening method for subclavian steal phenomena.

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P4707Incidence and outcome of endovascular therapy in subclavian occlusive disease involving the vertebral artery origin

European Heart Journal ◽

10.1093/eurheartj/ehz745.1088 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

V S Schneider ◽

R Dirschinger ◽

I Wustrow ◽

S Cassese ◽

M Fusaro ◽

...

Keyword(s):

Vertebral Artery ◽

Subclavian Artery ◽

Endovascular Therapy ◽

Innominate Artery ◽

Distal Segment ◽

Proximal Segment ◽

Special Focus ◽

Medial Segment ◽

Artery Disease

Abstract Background Endovascular revascularization represents the treatment option of choice in symptomatic steno-occlusive disease of the subclavian artery (SA). While the majority of lesions are localized in the proximal segment of the subclavian artery, studies in regards to the medial segment involving the vertebral artery (VA) origin are scarce. Purpose The aim of this study was to analyze the technical approaches and outcome of endovascular therapy of subclavian artery disease with a special focus on medial lesions involving the VA origin. Methods We retrospectively analyzed all patients who underwent percutaneous revascularization of the subclavian or innominate artery with a special focus on medial lesions involving the VA origin. Results In total 196 patients with subclavian or innominate artery intervention were analyzed. The majority of lesions (83%) were located in the proximal, whereas 28 patients (14%) presented with lesions in the medial segment of the SA, and only 3% involved the distal segment. Overall procedural success was high for both stenosis (96%) and occlusion (89%) and did not differ according to the lesion location. Revascularization techniques in the medial segment included stenting of the SA only (13 patients), additional VA balloon-dilatation (6 Patients), and bifurcational stenting of the SA and VA using T-stenting technique (9 patients). Overall periprocedural complication rate was low (6%) and comparable between different SA segments (6% in proximal segment vs. 7% in medial segment vs. 0% in distal segment; p=0.81). Outcome assessed after a median of 12 months (interquartile range 4–30) showed no significant differences in terms of Kaplan-Meier estimated freedom from restenosis between proximal and medial lesions despite the technically demanding approach in the medial segment (90% vs. 95%; p=0.67). Long-term patency Conclusion Endovascular revascularization of medial subclavian artery lesions involving the vertebral artery origin shows comparable safety and efficacy in terms of long-term patency rates compared to lesions located within the proximal subclavian artery. However, more complex endovascular techniques with bifurcational ballooning or stenting is required in a considerable number of patients with medial subclavian artery disease.

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Faculty Opinions recommendation of Editor's Choice - Management of Atherosclerotic Carotid and Vertebral Artery Disease: 2017 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS).

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.730661465.793576900 ◽

2020 ◽

Author(s):

Seemant Chaturvedi

Keyword(s):

Clinical Practice ◽

Vascular Surgery ◽

Vertebral Artery ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

European Society ◽

Artery Disease

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Variant origin of Common Interosseous Artery from Brachial Artery

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v2i3.8245 ◽

2017 ◽

Vol 2 (3) ◽

Author(s):

Pralhad D. Subbannavar

Keyword(s):

Brachial Artery ◽

The Body ◽

Dead Body ◽

Invasive Procedures ◽

Arterial Variations ◽

Statistical Inferences ◽

Individual Variations ◽

Interosseous Artery ◽

Cubital Fossa ◽

Dissection Techniques

Acharya Sushruta has emphasized the method and importance of dissection to study anatomy practically. Perfect knowledge of anatomy is vital for practicing surgeons and hence the training of dissecting the dead body was considered as mandatory for surgeons. Though dissection techniques may give the perception of the structure of organs, the pervading and subtle consciousness in the body can be experienced with the eyes of knowledge and penance only. Though the standard anatomy is defined based on statistical inferences on comparing large number of subjects, individual variations and exceptional structural specialties tend to occur quite frequently. Proper recording and publication of such instances would strengthen the knowledge base of the science. Knowledge regarding arterial variations of upper limb is important for surgeons and orthopedicians as they are commonly involved in invasive procedures. We report a case ofvariant origin of right common interosseous artery from brachial artery in cubital fossa. It followed a normal course after the origin.

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Continuous Arterial Infusion of 5-Fluorouracile in Patients with Advanced Breast Cancer

Tumori Journal ◽

10.1177/030089166705300507 ◽

1967 ◽

Vol 53 (5) ◽

pp. 503-514

Author(s):

Bruno Salvadori ◽

Leandro Gennari ◽

Sergio Di Pietro ◽

Umberto Veronesi

Keyword(s):

Breast Cancer ◽

Advanced Breast Cancer ◽

Subclavian Artery ◽

Brachial Artery ◽

Internal Mammary Artery ◽

Locally Advanced ◽

Advanced Breast ◽

Arterial Infusion ◽

Internal Mammary ◽

Anatomic Region

Fifteen women with advanced breast cancer underwent chemotherapeutical treatment with continuous arterial infusion of 5-Fluorouracile. The age of the patients ranged from 36 to 68 years; the patient of 36 had been previously ovariectomized. For cancer of internal or central quadrants of the breast, internal mammary artery was incannulated, while for those of the external ones, the tip of the catheter was led into subclavian artery through an arterotomy of brachial artery. In the cases in which the tumor was extended to the whole breast two vessels were incannulated, namely internal mammary and brachial artery. The drug was administered in a dose of 1 g a day, for a period of time ranging from 2 to 8 days, in 1000 ml of dextrose solution. The results of the treatment are the following: regression of more than 50% in 4 cases; regression of less than 50% in 5 cases; in 5 cases poor or no result was obtained. One woman died after one day of treatment from coma cerebralis. In 7 cases complications were observed, mainly spasm and thrombosis of the arteries and flittenular dermatitis; in 2 cases a decrease of WBC down to 3000/cmm was observed. In our experience, this method of chemotherapy seems to be indicated in a limited number of cases in which the tumor, though locally advanced, is still contained within the limits of the anatomic region. It is also indicated in case of local recurrences of tumors previously operated and expecially in carcinomatous mastitis.

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Off-pump coronary artery bypass concomitant with retrieval of broken guide wire stuck in the brachial artery: a case report

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-01867-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yuan Xue ◽

Lu Dai ◽

Wenjian Jiang ◽

Hongjia Zhang

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass ◽

Brachial Artery ◽

Guide Wire ◽

Artery Bypass ◽

Effective Means ◽

Coronary Intervention ◽

Off Pump ◽

Pump Coronary Artery Bypass ◽

The Right

Abstract Background The broken guide wire could get stuck anywhere during coronary artery angiography, but the broken guide wire in the brachial artery is extremely rare. Case presentation In this report, we describe our experience with a case of off-pump coronary artery bypass (OPCABG) concomitant with the retrieval of a broken guide wire stuck in the brachial artery: a 56-year-old male patient was referred to our hospital because of tri-vessel disease and a broken guide wire stuck in the right brachial artery. He received OPCABG concomitant with the retrieval of the broken guide wire stuck in the brachial artery under general anesthesia. The patient was discharged uneventfully, and 12 months follow-up showed an excellent surgical outcome. Conclusion Open surgery is an effective means for treating patients with a guide wire stuck in the brachial artery during percutaneous coronary intervention.

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