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Retrograde pedal access with a 20-gauge intravenous cannula after failed antegrade recanalization of a tibialis anterior artery in a diabetic patient: a case report.

Colkesen Y - Diabet Foot Ankle (2015)

Bottom Line: Retrograde tibiopedal approach is being used frequently in below-the-knee vascular interventions.In patients with diabetic foot pathology, complex anatomy often requires a retrograde technique when the distal vascular anatomy and puncture site is suitable.The dorsalis pedis and posterior tibial arteries can be punctured because of their relatively superficial position.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Seyhan Adana, Turkey; kardiyoloji@yahoo.com.

ABSTRACT
Retrograde tibiopedal approach is being used frequently in below-the-knee vascular interventions. In patients with diabetic foot pathology, complex anatomy often requires a retrograde technique when the distal vascular anatomy and puncture site is suitable. The dorsalis pedis and posterior tibial arteries can be punctured because of their relatively superficial position. We report a retrograde puncturing technique in patients with chronic total occlusions. After failed antegrade recanalization, puncturing and cannulation of a tiny dorsalis pedis artery with a narrow bore [20-gauge (0.8 mm)] intravenous cannula is described.

No MeSH data available.


Related in: MedlinePlus

(a) and (b) Final angiogram.
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Figure 0004: (a) and (b) Final angiogram.

Mentions: At that time, we were able to enter into the guiding catheter with the guidewire following successful guidewire passage via the tibialis anterior artery (Fig. 3). The OTW balloon was advanced into the guiding catheter. The guidewire was replaced with a 330-cm-long 0.014-inch exchange guidewire (RG3, Asahi Intecc, Aichi, Japan) for externalization. The guidewire was extracted via the right femoral sheath. The artery was predilated with a 2.0×20 mm monorail balloon (Invader PTCA balloon, Alvimedica, Assen, The Netherlands). A 2.5×200 mm drug eluting balloon (Legflow, Cardionovum, Bonn, Germany) was inflated for 3 min at the lesion site. The choice of balloon was at the operator's discretion. Final angiography demonstrated that antegrade flow was restored with well-visualized anterior tibial and dorsalis pedis arteries (Fig. 4a and b). Subsequently, successful hemostasis of the access site was exclusively obtained with manual compression. Wound healing has been perceived at the patient's first follow-up after 1 month.


Retrograde pedal access with a 20-gauge intravenous cannula after failed antegrade recanalization of a tibialis anterior artery in a diabetic patient: a case report.

Colkesen Y - Diabet Foot Ankle (2015)

(a) and (b) Final angiogram.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4530141&req=5

Figure 0004: (a) and (b) Final angiogram.
Mentions: At that time, we were able to enter into the guiding catheter with the guidewire following successful guidewire passage via the tibialis anterior artery (Fig. 3). The OTW balloon was advanced into the guiding catheter. The guidewire was replaced with a 330-cm-long 0.014-inch exchange guidewire (RG3, Asahi Intecc, Aichi, Japan) for externalization. The guidewire was extracted via the right femoral sheath. The artery was predilated with a 2.0×20 mm monorail balloon (Invader PTCA balloon, Alvimedica, Assen, The Netherlands). A 2.5×200 mm drug eluting balloon (Legflow, Cardionovum, Bonn, Germany) was inflated for 3 min at the lesion site. The choice of balloon was at the operator's discretion. Final angiography demonstrated that antegrade flow was restored with well-visualized anterior tibial and dorsalis pedis arteries (Fig. 4a and b). Subsequently, successful hemostasis of the access site was exclusively obtained with manual compression. Wound healing has been perceived at the patient's first follow-up after 1 month.

Bottom Line: Retrograde tibiopedal approach is being used frequently in below-the-knee vascular interventions.In patients with diabetic foot pathology, complex anatomy often requires a retrograde technique when the distal vascular anatomy and puncture site is suitable.The dorsalis pedis and posterior tibial arteries can be punctured because of their relatively superficial position.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Seyhan Adana, Turkey; kardiyoloji@yahoo.com.

ABSTRACT
Retrograde tibiopedal approach is being used frequently in below-the-knee vascular interventions. In patients with diabetic foot pathology, complex anatomy often requires a retrograde technique when the distal vascular anatomy and puncture site is suitable. The dorsalis pedis and posterior tibial arteries can be punctured because of their relatively superficial position. We report a retrograde puncturing technique in patients with chronic total occlusions. After failed antegrade recanalization, puncturing and cannulation of a tiny dorsalis pedis artery with a narrow bore [20-gauge (0.8 mm)] intravenous cannula is described.

No MeSH data available.


Related in: MedlinePlus