Antegrade selective catheterization of the superficial femoral artery using a movable-core guide wire.

Abstract

A simplified method of selective antegrade catheterization of the superficial femoral artery using a movable-core guide wire is described. This technique obviates the need for multiple catheter and guide wire manipulations and exchanges when preferential passage of the guide wire into the profunda femoral artery occurs following antegrade common femoral artery puncture.

Sonographically Guided Antegrade Common Femoral Artery Access

“…The difficulty in standard antegrade CFA access is evident by the availability of many imageguided adjunctive techniques reported. [1][2][3][4] Preferential entry of the needle guide wire system into the deep femoral artery or inadvertent puncture of the SFA or deep femoral artery may be difficult to avoid in palpation-guided CFA access, because the underlying arterial anatomic structures are not directly visible to the angiographers. The difficulty is even greater when the femoral pulse is difficult to locate.…”

“…Several methods have been used to facilitate standard antegrade CFA access. 3,4 However, they do not guarantee a proper CFA puncture above its bifurcation and an easy SFA cannulation. A more direct sonographically guided puncture has been used in difficult cases of retrograde CFA access, 5 but to the best of our knowledge, antegrade CFA access with SFA cannulation all under sonographic guidance has not been evaluated.…”

Easy technique for retro-antegrade superficial femoral artery catheterization

“…To facilitate the antegrade puncture of the CFA, various strategies have been described: the frog-leg position, modified angiographic needles or vessel dilators, specially shaped-curved catheters/dilators, ultrasoundassisted arterial punctures, or turning a curve vascular catheter in the ipsilateral iliac system or aorta (ipsilateral retrograde approach). [1][2][3][4][5][6][7][8] The contralateral retrograde puncture is the routine chosen approach for iliac, SFA, and popliteal lesions, but can be impractical in a variety of circumstances including infections of the groin, severe scarring from previous surgery, severe femoral atheromatous or iliac occlusive lesions. Moreover, the antegrade approach allows a more direct control of the catheter and wire than the retrograde puncture of the contralateral side and manipulation of wire and catheter over the Aortic bifurcation.…”

“…Moreover, the antegrade approach allows a more direct control of the catheter and wire than the retrograde puncture of the contralateral side and manipulation of wire and catheter over the Aortic bifurcation. 4 A retrograde femoral puncture is initially performed with an entry needle angle of approximately 60°. Although converting a retrograde into an antegrade access may be feasible in most patients, this maneuver may be difficult in obese individuals, given the distance from the skin to the vessel.…”

A new simple method of converting a retrograde femoral access to an antegrade catheterization

“…To facilitate the antegrade puncture of the CFA, various strategies have been described: the frog-leg position, the rebound technique, specially shaped curved catheters/dilators, modified angiographic needles or vessel dilators, turning a curve vascular catheter in the ipsilateral iliac system or aorta (ipsilateral retro-antegrade approach), and ultrasound-assisted arterial punctures. [1][2][3][4][5][6][7][8][9][10] We describe a new, easy technique for converting a retrograde into an antegrade CFA puncture using an inexpensive and universally available monofilament suture.…”