Static contrast technique for creating transpedal arterial access in patients with tibioperoneal occlusions John Chien-Hwa Chang, MD, Lau-Shen Lin, MD,

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Presentation transcript:

Static contrast technique for creating transpedal arterial access in patients with tibioperoneal occlusions John Chien-Hwa Chang, MD, Lau-Shen Lin, MD, Chih-Hung Chiu, MD Journal of Vascular Surgery Volume 58, Issue 4, Pages 1120-1122 (October 2013) DOI: 10.1016/j.jvs.2013.04.039 Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 1 Baseline angiography of the left lower leg showed superficial femoral artery (SFA) atherosclerosis without significant stenosis (a), chronic total occlusion (CTO) of the anterior and posterior tibial arteries (b), and the dorsalis pedis (arrow) reconstituted by collaterals (c). Journal of Vascular Surgery 2013 58, 1120-1122DOI: (10.1016/j.jvs.2013.04.039) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 2 A 5- × 150-mm balloon (Rival; Bard, Murray Hill, NJ) was inflated to 8 atm to occlude the distal superficial femoral artery (SFA) and popliteal artery (a, arrow), and 10 mL diluted iohexol contrast media was injected via a balloon catheter (a, double arrow). The contrast media was static in the pedal arteries, and the dorsalis pedis was punctured (b, arrow) with a 20-gage, 4-cm needle (b, double arrow) according to real-time roadmapping. After a subintimal approach to the anterior tibial artery, a double-balloon technique with two 2.5- × 120-mm balloons (Ampherion; Medtronic-Invatec, Roncadelle, Italy) was used, and the anterior tibial artery (c) was successfully revascularized. Journal of Vascular Surgery 2013 58, 1120-1122DOI: (10.1016/j.jvs.2013.04.039) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 3 Final angiography showed good flow in the anterior tibial artery without critical stenosis or flow-limiting dissections. Journal of Vascular Surgery 2013 58, 1120-1122DOI: (10.1016/j.jvs.2013.04.039) Copyright © 2013 Society for Vascular Surgery Terms and Conditions